title: Evaluation of patient-perceived health status using the Medical Outcomes Survey Short-Form 36 in an intensive care unit population.
abstract: OBJECTIVE
  Baseline patient functional status as assessed by providers is correlated with mortality after intensive care unit (ICU) admission. We wanted to see if patient self-perception of health status before admission to an ICU correlated with functional outcome.
  
  
  METHODS
  Prospective survey on a convenience sample.
  
  
  METHODS
  Single urban university-affiliated Veterans Affairs Medial Center.
  
  
  METHODS
  One hundred ninety-nine patients in surgical and medical/coronary ICUs.
  
  
  METHODS
  None.
  
  
  METHODS
  Patient-assessed baseline health status was monitored with the Medical Outcome Survey Short-Form 36 (SF-36), consisting of 36 questions that evaluate eight health status concepts. In addition, baseline functional status (Zubrod scale) was determined and severity of illness (Acute Physiology and Chronic Health Evaluation [APACHE] II) data were collected. Zubrod functional status, which includes mortality, was determined 6 wks and 6 months after ICU admission, and correlation coefficients were calculated.
  
  
  RESULTS
  We found it feasible to collect SF-36 health status data on a 9% sample in this setting. Less than 1% of responses were completed by proxy. The SF-36 data were internally consistent, and several of its scales including general health perception and physical functioning correlated with patient Zubrod functional status (r2 = .08, p < .001; r2 = .14, p < .001) at 6 wks as did vitality (r2 = .04, p < .01), social function (r2 = .03, p < .05), and physical role function (r2 = .02, p = .053), although to a lesser extent. Similar correlations were also found with 6-month functional status.
  
  
  CONCLUSIONS
  We conclude that use of the SF-36 is time efficient in an ICU setting and correlates with 6-wk and 6-month functional outcome. It correlates as well with functional outcome as either the baseline Zubrod functional status or the APACHE II severity of illness measurement. The five-question general health evaluation portion correlated almost as well with outcome as the more extensive 36-item questionnaire. Use of the SF-36 may define patient populations for comparison across hospitals. It may also target individuals with needs for additional posthospitalization care, including rehabilitation services or nursing home placement.
authors.affiliation: Department of Medicine, Denver Veterans Affairs Medical Center, University of Colorado Health Sciences Center, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Welsh
authors.forename: K
authors.initials: K
authors.lastname: Thompson
authors.forename: S
authors.initials: S
authors.lastname: Long-Krug
mesh_terms: D018806:APACHE; D000203:Activities of Daily Living; D001294:Attitude to Health; D003120:Colorado; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006787:Hospitals, Veterans; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs