title: Symptom burden and health-related quality of life among intensive care unit survivors in Argentina: A prospective cohort study.
abstract: OBJECTIVE
  Our goal was to describe the evolution of selected physical and psychologic symptoms and identify the determinants of health-related quality of life (HRQOL) after intensive care unit (ICU) discharge.
  
  
  METHODS
  The study is a prospective cohort of consecutive adult patients admitted to a mixed ICU in a university-affiliated hospital, mechanically ventilated for more than 48 hours. During ICU stay, epidemiological data and events probably associated to worsening outcomes were recorded. After discharge, patients were interviewed at 1, 3, 6, and 12 months. Health-related quality of life was assessed with EuroQoL Questionnaire-5 Dimensions, which includes the EQ-index and EQ-Visual Analogue Scale.
  
  
  RESULTS
  One hundred twelve patients were followed up, aged 33 [24-49] years, 68% male, 76% previously healthy, and cranial trauma was the main diagnosis. Physical and psychologic symptoms and moderate/severe problems according to the EQ index progressively decreased after discharge, yet were still highly prevalent after 1 year. EQ index improved from 0.22 [0.01-0.69] to 0.52 [0.08-0.81], 0.66 [0.17-0.79], and 0.68 [0.26-0.86] (P < .001, for all vs month 1). EQ-Visual Analogue Scale remained stable, within acceptable values. Independent determinants of EQ-index were time, duration of mechanical ventilation, shock, weakness, and return to study/work.
  
  
  CONCLUSIONS
  Determinants of HRQOL after ICU discharge were both related to late sequelae of critical illness and to some events occurring in the ICU. Notwithstanding the high symptom burden, patients still perceived their HRQOL as good.
authors.affiliation: Servicio de Terapia Intensiva, Hospital Interzonal General de Agudos San Martin de La Plata 1 y 70, 1900 La Plata, Buenos Aires, Argentina.
authors.forename: Andrea V
authors.initials: AV
authors.lastname: Das Neves
authors.affiliation: Servicio de Terapia Intensiva, Sanatorio Anchorena, Tomas de Anchorena, C1425ELP, 1872 Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Daniela N
authors.initials: DN
authors.lastname: Vasquez
authors.affiliation: Servicio de Terapia Intensiva, Hospital Interzonal General de Agudos San Martin de La Plata 1 y 70, 1900 La Plata, Buenos Aires, Argentina.
authors.forename: Cecilia I
authors.initials: CI
authors.lastname: Loudet
authors.affiliation: Servicio de Terapia Intensiva, Sanatorio Anchorena, Tomas de Anchorena, C1425ELP, 1872 Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Dante
authors.initials: D
authors.lastname: Intile
authors.affiliation: Servicio de Terapia Intensiva, Hospital Interzonal General de Agudos San Martin de La Plata 1 y 70, 1900 La Plata, Buenos Aires, Argentina.
authors.forename: María Gabriela
authors.initials: MG
authors.lastname: Sáenz
authors.affiliation: Servicio de Terapia Intensiva, Hospital Interzonal General de Agudos San Martin de La Plata 1 y 70, 1900 La Plata, Buenos Aires, Argentina.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Marchena
authors.affiliation: Servicio de Terapia Intensiva, Hospital Interzonal General de Agudos San Martin de La Plata 1 y 70, 1900 La Plata, Buenos Aires, Argentina.
authors.forename: Ana L
authors.initials: AL
authors.lastname: Gonzalez
authors.affiliation: Instituto del Diagnostico, 62 n° 370, 1900 La Plata, Buenos Aires, Argentina.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Moreira
authors.affiliation: Servicio de Terapia Intensiva, Hospital Interzonal General de Agudos San Martin de La Plata 1 y 70, 1900 La Plata, Buenos Aires, Argentina.
authors.forename: Rosa
authors.initials: R
authors.lastname: Reina
authors.affiliation: Servicio de Terapia Intensiva, Hospital Interzonal General de Agudos San Martin de La Plata 1 y 70, 1900 La Plata, Buenos Aires, Argentina. Electronic address: estenssoro.elisa@gmail.com.
authors.forename: Elisa
authors.initials: E
authors.lastname: Estenssoro
mesh_terms: D000328:Adult; D001118:Argentina; D001930:Brain Injuries / Q000523:psychology; D017281:Cost of Illness; D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D011788:Quality of Life; D012121:Respiration, Artificial; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult
keywords: Critical care; EuroQol-5D; HRQOL; Mechanical ventilation duration; Traumatic brain injury sequelae; Weakness