Quality of life after complicated elective surgery requiring intensive care.
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.
Lamer
Christian
C
Département de Réanimation Polyvalente, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75674 Paris, France. christian.lamer@imm.fr
Harboun
Marc
M
Knani
Lyes
L
Moreau
David
D
Tric
Laurent
L
LeGuillou
Jean-Luc
JL
Gasquet
Isabelle
I
Moreau
Thierry
T
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