title: Examining discharge outcomes and health status of critically ill patients: some practical considerations.
abstract: 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.
authors.affiliation: Prince of Wales Hospital, Randwick and Department of Clinical Nursing, The University of Sydney, Sydney, NSW 2006, Australia. delliott@nursing.usyd.edu.au
authors.forename: Doug
authors.initials: D
authors.lastname: Elliott
authors.forename: Yugan
authors.initials: Y
authors.lastname: Mudaliar
authors.forename: Carolyn
authors.initials: C
authors.lastname: Kim
mesh_terms: 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