Examining discharge outcomes and health status of critically ill patients: some practical considerations.
This prospective observational study examined the outcomes of 200 consecutive admissions to an adult tertiary level Intensive Care Unit (ICU). Eligible and consenting participants were also involved in a sub-study that examined health status at four measurement points from pre-illness to 6 months post-discharge. Of the 189 individual patients admitted, 23% died in ICU and 57% were discharged home. The health status sub-study enrolled 34 participants (39% of eligible patients) who were representative of the ICU population for demographic and clinical variables. Surviving participants returned to a similar, though not identical state of health at 6 months post-discharge, when compared to their pre-ICU health-state using the 15D and SF-36 instruments. Health status at ICU discharge was significantly impaired when compared to other measurement points, particularly for mobility, breathing, eating, usual activities and vitality. A number of methodological challenges were evident, particularly for the health status sub-study, including prospective subject recruitment and retention, losses to follow-up and instrument responsiveness. Despite the limitations noted, the study provided useful findings and recommendations for the continued development of methods to examine the health status of critically ill patients.
Elliott
Doug
D
Prince of Wales Hospital, Randwick and Department of Clinical Nursing, The University of Sydney, Sydney, NSW 2006, Australia. delliott@nursing.usyd.edu.au
Mudaliar
Yugan
Y
Kim
Carolyn
C
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003422:Critical Care / Q000592:standards*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D005260:Female; D006302:Health Services Research; D006304:Health Status; D017052:Hospital Mortality; D006786:Hospitals, Urban; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D016019:Survival Analysis