A comparison of outcomes among hospital survivors with and without severe comorbidity admitted to the intensive care unit.
Little is known about the experiences of patients with severe comorbidity discharged from Intensive Care Units (ICUs). This project aimed to determine the effects of an ICU stay for patients with severe comorbidity by comparing 1) quality of life (QOL), 2) the symptom profile of hospital survivors and 3) health service use after hospital discharge for patients admitted to ICU with and without severe comorbidity. A case-control study was used. Patients with severe comorbidity were matched to a contemporaneous cohort of ICU patients by age and severity of illness. Assessment tools were the Medical Outcome Study 36-item short-form and European Organisation for Research and Treatment of Cancer QLQ-C15-PAL questionnaires for QOL and the Symptom Assessment Scale for symptom distress. A proportional odds assumption was performed using an ordinal regression model. The difference in QOL outcome was the dependent variable for each pair. Health service use after discharge from ICU was monitored with patient diaries. Patients aged 18+ years admitted to an ICU in a metropolitan teaching hospital between 2011 and 2012 were included. We recruited 30 cases and 30 controls. QOL improved over the six months after hospital discharge for patients with and without severe comorbidity (P <0.01) within the groups but there was no difference found between the groups (P >0.3). There was no difference in symptoms or health service use between patients with and without severe comorbidity. ICU admission for people with severe comorbidity can be appropriate to stabilise the patient's condition and is likely to be followed by some overall improvement over the six months after hospital discharge.
School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Bentley, Western Australia.
T A
TA
Williams
School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Bentley, Western Australia.
R
R
McConigley
School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Bentley, Western Australia.
G D
GD
Leslie
Intensive Care Unit, Royal Perth Hospital, and School of Medicine and Clinical Professor of Pharmacology, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia.
G J
GJ
Dobbs
Western Australian Institute for Medical Research, University of Western Australia and Royal Perth Hospital, Perth, Western Australia.
M
M
Phillips
Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia.
H
H
Davies
School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Bentley, Western Australia.
S
S
Aoun
D000203:Activities of Daily Living; D001315:Australia; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D010351:Patient Discharge; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*
ICU; comorbidity; healthcare utilisation; quality of life