title: The role of memories on health-related quality of life after intensive care unit care: an unforgettable controversy?
abstract: BACKGROUND
  Decreased health-related quality of life (HRQoL) is a significant problem after an intensive care stay and is affected by several known factors such as age, sex, and previous health-state. The objective of this study was to assess the association between memory and self-reported perceived HRQoL of patients discharged from the intensive care unit (ICU).
  
  
  METHODS
  A prospective, multicenter study involving nine general ICUs in Portugal. All adult patients with a length of stay >48 hours were invited to participate in a 6-month follow-up after ICU discharge by answering a set of structured questionnaires, including EuroQol 5-Dimensions and ICU memory tool.
  
  
  RESULTS
  A total of 313 (52% of the eligible) patients agreed to enter the study. The median age of patients was 60 years old, 58% were males, the median Simplified Acute Physiology Score II (SAPS II) was 38, and the median length of stay was 8 days for ICU and 21 days for total hospital stay. Eighty-nine percent (n=276) of the admissions were emergencies. Seventy-eight percent (n=234) of the patients had memories associated with the ICU stay. Patients with no memories had 2.1 higher chances (P=0.011) of being in the bottom half of the HRQoL score (<0.5 Euro-Qol 5-Dimensions index score). Even after adjusting for pre-admission characteristics, having memories was associated with higher perceived HRQoL (adjusted odds ratio =2.1, P=0.022).
  
  
  CONCLUSIONS
  This study suggests that most of the ICU survivors have memories of their ICU stay. For the ICU survivors, having memories of the ICU stay is associated with a higher perceived HRQoL 6 months after ICU discharge.
authors.affiliation: Department of Health Information and Decision Sciences, Faculty of Medicine of Porto, Porto, Portugal; CINTESIS - Centre for Research in Health Technologies and Health Systems, Faculty of Medicine of Porto, Porto, Portugal; Department of Intensive Care, Linköping University, County Council of Östergötland, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Lotti
authors.initials: L
authors.lastname: Orwelius
authors.affiliation: CINTESIS - Centre for Research in Health Technologies and Health Systems, Faculty of Medicine of Porto, Porto, Portugal; Screening and Test Evaluation Program, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
authors.forename: Armando
authors.initials: A
authors.lastname: Teixeira-Pinto
authors.affiliation: CINTESIS - Centre for Research in Health Technologies and Health Systems, Faculty of Medicine of Porto, Porto, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lobo
authors.affiliation: Department of Health Information and Decision Sciences, Faculty of Medicine of Porto, Porto, Portugal; CINTESIS - Centre for Research in Health Technologies and Health Systems, Faculty of Medicine of Porto, Porto, Portugal.
authors.forename: Altamiro
authors.initials: A
authors.lastname: Costa-Pereira
authors.affiliation: Department of Health Information and Decision Sciences, Faculty of Medicine of Porto, Porto, Portugal; CINTESIS - Centre for Research in Health Technologies and Health Systems, Faculty of Medicine of Porto, Porto, Portugal; Department of Emergency and Intensive Care Medicine, Algarve Hospital Centre, Algarve, Portugal; Department of Biomedical Sciences and Medicine, University of Algarve, Algarve, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Granja
keywords: critical care; health-related quality of life; memory disturbances; outcome