title: Intensive care unit acquired infection has no impact on long-term survival or quality of life: a prospective cohort study.
abstract: BACKGROUND
  The aim of this study was to evaluate the impact of intensive care unit (ICU)-acquired infection on long-term survival and quality of life.
  
  
  METHODS
  Long-term survival was prospectively evaluated among hospital survivors who had stayed in a mixed, university-level ICU for longer than 48 hours during a 14-month study period during 2002 to 2003. Health-related quality of life was assessed using the five-dimensional EuroQol (EQ-5D) questionnaire in January 2005.
  
  
  RESULTS
  Of the 272 hospital survivors, 83 (30.5%) died after discharge during the follow-up period. The median follow-up time after hospital discharge was 22 months. Among patients without infection on admission, long-term mortality did not differ between patients who developed and those who did not develop an ICU-acquired infection (21.7% versus 26.9%; P = 0.41). Also, among patients with infection on admission, there was no difference in long-term mortality between patients who developed a superimposed (35.1%) and those who did not develop a superimposed (27.6%) ICU-acquired infection (P = 0.40). The EQ-5D response rate was 75 %. The patients who developed an ICU-acquired infection had significantly more problems with self-care (50%) than did those without an ICU-acquired infection (32%; P = 0.004), whereas multivariate analysis did not show ICU-acquired infection to be a significant risk factor for diminished self-care (odds ratio = 1.71, 95% confidence interval = 0.65-4.54; P = 0.28). General health status did not differ between those with and those without an ICU-acquired infection, as measured using the EuroQol visual-analogue scale (mean +/- standard deviation EuroQol visual-analogue scale value: 60.2 +/- 21 in patients without ICU-acquired infection versus 60.6 +/- 22 in those with ICU-acquired infection). The current general level of health compared with status before ICU admission did not differ between the groups either. Only 36% of those employed resumed their previous jobs.
  
  
  CONCLUSIONS
  ICU-acquired infection had no impact on long-term survival. The patients with ICU-acquired infection more frequently experienced problems with self-care than did those without ICU infection, but ICU-acquired infection was not a significant risk factor for diminished self-care in multivariate analysis.
authors.affiliation: Department of Infection Control, Oulu University Hospital, P,O, Box 22, FIN-90029 OYS, Finland. pekka.ylipalosaari@oulu.fi
authors.forename: Pekka
authors.initials: P
authors.lastname: Ylipalosaari
authors.forename: Tero I
authors.initials: TI
authors.lastname: Ala-Kokko
authors.forename: Jouko
authors.initials: J
authors.lastname: Laurila
authors.forename: Pasi
authors.initials: P
authors.lastname: Ohtonen
authors.forename: Hannu
authors.initials: H
authors.lastname: Syrjälä
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003428:Cross Infection / Q000401:mortality* / Q000628:therapy; D005260:Female; D005387:Finland; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life; D015996:Survival Rate; D016896:Treatment Outcome