[Survival and quality of life of patients with multiple organ failure one year after leaving an intensive care unit].
BACKGROUND
The patients' mortality with multiple organ failure (MOF) is very high and patients who consume the most resources are those with uncertain prognosis. In order to use the limited resources adequately, it is necessary to know the cost-benefit relationship of their treatment and in this study cost, mortality, quality of life (QOL) of survivors who developed MOF has been investigated.


METHODS
Mortality in the Intensive Care Unit (ICU) and mortality QOL (with modified EuroQOL Instrument) one year after discharge were studied in 239 admitted patients who developed MOF. Cost was estimated from administrative dats of cost patients-day. To determine mortality independent predicting factors, a logistic regression model was used.


RESULTS
Of the 239 patients studied, 144 (60%) died in ICU and 29 (12%) died after discharge. The independent predicting factors of mortality one year after discharge from ICU were: age (p < 0.1, odds ratio [OR] = 1.02), cardiac surgery (p < 0.0000, OR = 0.1899) and trauma (p < 0.05, OR = 0.2287). Of the 66 surviving patients, 18% were severely discapacitated. Forty one percent recovered their previous QOL, 18% improved it and 39% got worse. Patients with MOF consumed 64% of ICU total resources and of these, 77% was consumed by patients who died and by severely discapacitated.


CONCLUSIONS
A high proportion of resources were used by MOF patients, but patients who died and who remained with worst QOL consumed the highest part. Although the mortality after one year was high (72%), 80% of the survivors achieved an acceptable QOL and for this reason, treatment of these patients should not be limited if survival and QOL predictions are not 100% correct.
García Lizana
F
F
Unidades de Medicina Intensiva, Hospital Nuestra Señora del Pino. fglizana@idecnet.com
Manzano Alonso
J L
JL
González Santana
B
B
Fuentes Esteban
J
J
Saavedra Santana
P
P
D003362:Cost-Benefit Analysis; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D016015:Logistic Models; D009102:Multiple Organ Failure / Q000191:economics / Q000401:mortality / Q000628:therapy; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D018434:Sickness Impact Profile; D013030:Spain; D016019:Survival Analysis; D017741:Survivors