title: Health-related quality of life of patients with multiple organ dysfunction: individual changes and comparison with normative population.
abstract: OBJECTIVE
  To determine health-related quality of life in medical intensive care patients with multiple organ dysfunction.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  A 12-bed, noncoronary, medical intensive care unit of a university hospital.
  
  
  METHODS
  Between June 1998 and May 1999, 318 consecutively admitted adult patients with an intensive care unit stay of >24 hrs were studied.
  
  
  RESULTS
  Health-related quality of life was assessed using a generic instrument, the Medical Outcomes Study Short Form-36 Health Survey, at admission and at 6-month follow-up. Patients who developed multiple organ dysfunction (n = 170) consumed 85% of the therapeutic activity provided in the intensive care unit. Compared with age- and sex-adjusted general population controls, multiple organ dysfunction patients had a worse preadmission health-related quality of life than other intensive care unit patients, predominantly due to a higher burden of comorbid disease. In a multivariate analysis, multiple organ dysfunction was the only variable independently associated with deteriorated physical health domains at follow-up (odds ratio, 4.4; 95% confidence interval, 1.3-14.6; p =.015), but it had no impact on dimensions of mental health. Analyzing the impact of different organ system failures, respiratory failure (odds ratio, 4.1; 95% confidence interval, 1.6-10.3; p =.002) and acute renal failure (odds ratio, 3.3; 95% confidence interval, 1.0-11.5; p =.05) increased the risk of deteriorated physical health at follow-up. No impact of the various organ system failures on mental health was noted. At 6-month follow-up, 83-90% of survivors had regained their previous health-related quality of life, and 94% were living at home with their families.
  
  
  CONCLUSIONS
  This study has shown that preadmission health-related quality of life of our medical, noncoronary patients was substantially reduced compared with a matched general population. This demonstrates the need to take prehospitalization health-related quality of life into account when examining the outcomes of intensive care unit survivors. Multiple organ dysfunction was the major determinant of poor physical health at follow-up, but it had no impact on mental health domains.
authors.affiliation: Departments of Medicine I, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Wehler
authors.forename: Arnim
authors.initials: A
authors.lastname: Geise
authors.forename: Dijana
authors.initials: D
authors.lastname: Hadzionerovic
authors.forename: Emgijada
authors.initials: E
authors.lastname: Aljukic
authors.forename: Udo
authors.initials: U
authors.lastname: Reulbach
authors.forename: Eckhart Georg
authors.initials: EG
authors.lastname: Hahn
authors.forename: Richard
authors.initials: R
authors.lastname: Strauss
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009102:Multiple Organ Failure; D011788:Quality of Life; D011795:Surveys and Questionnaires