Changes in quality of life after medical intensive care.
OBJECTIVE
To determine outcome and changes in health-related quality of life (QOL) in medical intensive care patients.


METHODS
Prospective comparison of QOL before and 6 months after intensive care unit (ICU) admission in a 12-bed noncoronary medical ICU of a university hospital.


METHODS
All 325 consecutively admitted adult patients who spent at least 24 h on the ICU were eligible.


RESULTS
QOL measurements were collected before and 6 months after ICU admission. Comorbidity classified by the Charlson index was 2.44 +/- 1.96. Mean stay in the ICU was 10.4 +/- 15.1 days, mean Acute Physiology and Chronic Health Evaluation II score was 23 +/- 10. Cumulative mortality was: ICU 24 %, hospital 34 %, 6 months 43 %. Relative to baseline, follow-up interviews of 185 survivors revealed no significant changes in the overall QOL score (p = 0.93). The subscales basic physiological activities (p = 0.07) and normal daily activities (p = 0.15) showed a nonsignificant deterioration. A significant improvement was noted for the domain emotional state (p = 0.013).


CONCLUSIONS
Six months after admission to a medical ICU most survivors had regained their preadmission health-related QOL. Multivariate analysis showed that preadmission QOL, age, and severity of illness were most strongly associated with follow-up QOL. Of the survivors 86 % were living at home, and all but one of those previously in employment had returned to their former work. Most patients (94%) would undergo ICU treatment again if necessary.
Department of Medicine I of the University of Erlangen-Nuremberg, Germany. markus.wehler@med1.imed.uni-erlangen.de
M
M
Wehler
P
P
Martus
A
A
Geise
A
A
Bost
A
A
Mueller
E G
EG
Hahn
R
R
Strauss
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D015996:Survival Rate