title: Quality of life after complicated elective surgery requiring intensive care.
abstract: OBJECTIVE
  To evaluate outcomes of patients admitted to the ICU for complications after elective surgery and to assess perceived quality of life (pQOL) in survivors.
  
  
  METHODS
  Two-year prospective case-control study.
  
  
  METHODS
  Twelve-bed ICU in a university-affiliated hospital.
  
  
  METHODS
  Patients admitted to the ICU for a complication following elective surgery were included. Six months after discharge, pQOL was assessed using the Nottingham Health Profile (NHP). Results were compared to those of matched controls without complications.
  
  
  METHODS
  None.
  
  
  RESULTS
  Of the 182 patients, 124 were alive after 6 months, among whom 116 had 6-month data and 104 of these had matched controls. Overall pQOL as assessed by the global NHP score was similar in both groups (median, 0.82 and 0.87 in cases and controls; P=0.24). NHP subscores showed significantly worse pain ( P=0.03) and physical impairment ( P=0.02) in the ICU patients. In the multivariate analysis, pQOL was better in patients with cancer as the reason for surgery ( P=0.05). Severity of illness at inclusion had no influence on subsequent pQOL, but cardiovascular dysfunction was associated with decreased energy ( P=0.04).
  
  
  CONCLUSIONS
  Although overall pQOL was satisfactory after 6 months, patients admitted to the ICU for postoperative complications had worse pain and physical impairment than controls. Whether these outcomes could be improved by early physiotherapy and aggressive pain management deserves investigation.
authors.affiliation: Département de Réanimation Polyvalente, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75674 Paris, France. christian.lamer@imm.fr
authors.forename: Christian
authors.initials: C
authors.lastname: Lamer
authors.forename: Marc
authors.initials: M
authors.lastname: Harboun
authors.forename: Lyes
authors.initials: L
authors.lastname: Knani
authors.forename: David
authors.initials: D
authors.lastname: Moreau
authors.forename: Laurent
authors.initials: L
authors.lastname: Tric
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: LeGuillou
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gasquet
authors.forename: Thierry
authors.initials: T
authors.lastname: Moreau
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003422:Critical Care; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D018709:Statistics, Nonparametric