title: Our paper 20 years later: 1-year survival and 6-month quality of life after intensive care.
abstract: BACKGROUND
  In the early 1990s, the in-hospital mortality rate of intensive care unit (ICU) patients dropped, and interest in the quality of life (QOL) of ICU survivors increased. In 1996, we published a study to investigate 1-year survival after hospital discharge and 6-month QOL after intensive care. Now, we compare our previous results with those reported in the recent literature to appraise any changes, and new knowledge in the area.
  
  
  RESULTS
  The 1-year survival of ICU patients after hospital discharge is substantial, lower than in the general population, and different among subgroups. Some studies showed a reduction in QOL at 6 months, as in our study, while others showed an improvement. Different results seem to be related mainly to the case mix. Studies on different types of patients found long-term cognitive impairment in ICU survivors, possibly not disease specific. The proportions of patients with neuropsychological morbidities such as posttraumatic stress disorder, anxiety, and depression, described after our study, did not show any change over time.
  
  
  CONCLUSIONS
  Differences between studies on long-term survival and QOL do not allow conclusions to be drawn about change over time. No change was found in neuropsychological morbidities. However, a lack of change may not be viewed negatively, because critically ill patients who survive ICU today may be at higher risk for poor long-term outcome than in the past due to the higher severity of their illness and the more aggressive treatments received. Future studies may provide understanding of the relationships between psychiatric symptoms, cognitive impairment, functional disability, and QOL.
authors.affiliation: c/o Section of Anaesthesia and Intensive Care, Department of Morphology, Surgery and Experimental Medicine, S. Anna Hospital, University of Ferrara, Via Aldo Moro 8, Cona, 44124, Ferrara, Italy, cpm@unife.it.
authors.forename: Maurizia
authors.initials: M
authors.lastname: Capuzzo
authors.forename: Margherita
authors.initials: M
authors.lastname: Bianconi
mesh_terms: D000368:Aged; D003422:Critical Care / Q000523:psychology; D016638:Critical Illness / Q000401:mortality / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D015996:Survival Rate