title: The impact of medical conditions on the quality of life of survivors at discharge from intensive care unit.
abstract: OBJECTIVE
  Impaired health-related quality of life (HRQOL) is one of the possible outcomes after discharge from an intensive care unit (ICU). Evaluation of patient health status on discharge from the ICU would help identify factors influencing changes in HRQOL after ICU discharge. The objective of the study was to identify whether health state on discharge from prolonged stay in the ICU has any influence on survivors' HRQOL 6 months after intensive care.
  
  
  METHODS
  A prospective study of patients with the prolonged length of stay (exceeding 7 days) in the ICU was conducted. The study covered the impact of organ system dysfunction (SOFA score), number of therapeutic interventions (TISS-28 score), and critical illness neuromuscular abnormalities (CINMA) on discharge from the ICU on HRQOL 6 months following ICU discharge.
  
  
  RESULTS
  In total, 137 patients were included in the study. The SOFA score on the last day in the ICU was 2.91 (SD, 1.57); the TISS-28 score on the last day in the ICU was 21.79 (SD, 4.53). Decreased physical functioning (PF) and role physical (RP) were identified. Circulatory impairment on discharge from the ICU had an impact on decreased PF (P=0.016), role physical (P=0.066), and role emotional (P=0.001). Patients with dysfunction in more than one organ system on ICU discharge had decreased role emotional (P=0.016). Severe CINMA was diagnosed in 18 patients. They had decreased PF (P=0.007) and RP (P=0.019). Patients with the TISS-28 score above or equal to 20 points showed lower HRQOL in the PF domain (P=0.077) and general health (P=0.038).
  
  
  CONCLUSIONS
  HRQOL in patients with prolonged stay in the ICU is particularly impaired in the domains of physical functioning and role physical. It is associated with circulatory impairment, CINMA, and greater number of therapeutic interventions on discharge from the ICU.
authors.affiliation: Clinic of Anesthesiology and Intensive Care, Vilnius University Hospital Santariškių Klinikos, Santariškių 2, Vilnius, Lithuania. andrius.klimasauskas@santa.lt
authors.forename: Andrius
authors.initials: A
authors.lastname: Klimašauskas
authors.forename: Ieva
authors.initials: I
authors.lastname: Sereikė
authors.forename: Aušra
authors.initials: A
authors.lastname: Klimašauskienė
authors.forename: Gintautas
authors.initials: G
authors.lastname: Kėkštas
authors.forename: Juozas
authors.initials: J
authors.lastname: Ivaškevičius
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*; D055815:Young Adult