title: Risk factors for worsened quality of life in patients on mechanical ventilation. A prospective multicenter study.
abstract: OBJECTIVE
  To identify risk factors for worsened quality of life (QoL) and activities of daily living (ADL) at 3 and 12 months after discharge from the Intensive Care Unit (ICU) in patients on mechanical ventilation (MV).
  
  
  METHODS
  A prospective, multicentric observational study was made.
  
  
  METHODS
  Three ICUs in Argentina.
  
  
  METHODS
  The study included a total of 84 out of 129 mainly clinical patients admitted between 2011-2012 and requiring over 24hours of MV.
  
  
  METHODS
  No interventions were carried out.
  
  
  METHODS
  Quality of life was assessed with the EQ-5D (version for Argentina), and ADL with the Barthel index.
  
  
  RESULTS
  The EQ-5D and Barthel scores were assessed upon admission to the ICU (baseline) and after three months and one year of follow-up. Comorbidities, delirium, ICU acquired weakness (ICUAW), and medication received were daily assessed during ICU stay. The baseline QoL of the global sample showed a median index of [0.831 (IQR25-75% 0.527-0.931)], versus [0.513 (IQR0.245-0.838)] after three months and [0.850 (IQR0.573-1.00)] after one year. Significant differences were observed compared with QoL in the Argentinean general population [mean 0.880 (CI 0.872-0.888), p<0.001; p<0.001; p0.002]. Individual analysis showed that 67% of the patients had worsened their QoL at three months, while 33% had recovered their QoL. In the multivariate analysis, the variables found to be independent predictors of worsened QoL were a hospital stay ≥21 days [OR 12.57 (2.75-57.47)], age ≥50 years [OR 5.61 (1.27-24.83)], previous poor QoL [OR 0.11 (0.02-0.54)] and persistent ICUAW [OR 8.32 (1.22-56.74)]. Similar results were found for the worsening of ADL.
  
  
  CONCLUSIONS
  Quality of life is altered after critical illness, and its recovery is gradual over time. Age, length of hospital stay, previous QoL and persistent ICUAW seem to be risk factors for worsened QoL.
authors.affiliation: Unidad de Terapia Intensiva, Clínica Olivos SMG, Buenos Aires, Argentina. Electronic address: marinabusico@yahoo.com.ar.
authors.forename: M
authors.initials: M
authors.lastname: Busico
authors.affiliation: Unidad de Terapia Intensiva, Sanatorio Anchorena, CABA, Argentina.
authors.forename: D
authors.initials: D
authors.lastname: Intile
authors.affiliation: Servicio de Neumonologia, Hospital Ramos Mejía, CABA, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Sívori
authors.affiliation: Unidad de Terapia Intensiva, Sanatorio Anchorena, CABA, Argentina.
authors.forename: N
authors.initials: N
authors.lastname: Irastorza
authors.affiliation: Unidad de Terapia Intensiva, Clínica Bazterrica, CABA, Argentina.
authors.forename: A L
authors.initials: AL
authors.lastname: Alvarez
authors.affiliation: Unidad de Terapia Intensiva, Clínica Olivos SMG, Buenos Aires, Argentina.
authors.forename: J
authors.initials: J
authors.lastname: Quintana
authors.affiliation: Unidad de Terapia Intensiva, Clínica Bazterrica, CABA, Argentina.
authors.forename: L
authors.initials: L
authors.lastname: Vazquez
authors.affiliation: Unidad de Terapia Intensiva, Sanatorio Anchorena, CABA, Argentina.
authors.forename: G
authors.initials: G
authors.lastname: Plotnikow
authors.affiliation: Unidad de Terapia Intensiva, Clínica Olivos SMG, Buenos Aires, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: Villarejo
authors.affiliation: Unidad de Terapia Intensiva, Sanatorio Anchorena, CABA, Argentina.
authors.forename: P
authors.initials: P
authors.lastname: Desmery
mesh_terms: D000203:Activities of Daily Living; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D011446:Prospective Studies; D011788:Quality of Life; D012121:Respiration, Artificial; D012307:Risk Factors
keywords: Calidad de vida relacionada a la salud; Cuidado intensivo; Factores de riesgo; Follow-up; Health related quality of life; Intensive care; Mechanical ventilation; Risk factors; Seguimiento; Ventilación mecánica