Survival and quality of life of patients treated in intensive care unit
Abstract
Background: The aims of our study were to determine short-term and long-term survival of critically ill surgical patients and to assess quality of life of survivors of critical illness.
Methods: In observational study we included all patients admitted to the surgical intensive care unit (SICU) during a 1-year period (January 2003 through December 2003). Quality of life was assessed after 2 years following intensive care admission for surviving patients using the EuroQol 5D (EQ-5D) questionnaire.
Results: A total of 325 patients were included in the study. 70 patients died on surgical intensive care (21.5 % mortality), a further 40 died on the general ward after SICU discharge (hospital mortality 33.8 %) and 41 following discharge home (2-year mortality 46.9 %). For those surviving intensive care first year mortality was almost 8 times higher and second year mortality almost 6 times higher than that of an age- and sex-matched general population. We had assessed quality of life in 94 patients (55 %) of 171 surviving patients after 2 years. The mean EQ-5D was 0.70 ± 0.25. 86 % of patients reported a problem in at least one dimension of EQ-5D. Most of surviving patients 93.6 % (88/94) returned to home. 50 % (13/26) of patients who were employed before SICU admission were back at their previous work after 2 years.
Conclusions: Intensive care survivors have also higher mortality rate after hospital discharge compared with that of the general population. Most of patients returned to home after surviving critical illness and lived contentedly, but only 50 % of patients who were employed before SICU admission were back at their previous work after 2 years.
Downloads
References
Chang SY, Multz AS, Hall JB. Critical care organization. Crit Care Clin 2005; 21: 43–53.
Angus DC, Carlet J on behalf of the 2002 Brussels Roundtable Participants. Surviving intensive care: a report from the 2002 Brussels Roundtable. Intensive Care Medicine 2003; 29: 368–77.
Needham DM, Dowdy DW, Mendez-Tellez PA, Herridge MS, Pronovost PJ. Studying outcomes of intensive care unit survivors: measuring exposures and outcomes. Intensive Care Med 2005; 31: 1153–60.
The EuroQol Group. EuroQol – a new facility for the measurement of health-related quality of life. Health Policy 1990; 16: 199– 208.
EQ-5D: An Instrument to describe and value health. Dosegljivo na: www.euroqol.org
Calculating the U.S. Population-based EQ-5D Index Score. February 2005. Agency for Healthcare Research and Quality, Rockville, MD. Dosegljivo na: www.ahrq.gov/rice/EQ5Dscore.htm
Wright JC, Plenderleith L, Ridley SA. Long-term survival following intensive care: Subgroup analysis and comparison with the general population. Anaesthesia 2003; 58: 637–42.
Goldhill RD, Sumner A. Outcome of intensive care patients in a group of British intensive care units. Crit Care Med 1998; 26: 1337–45.
Trivedi M, Ridley SA. Intermediate outcome of medical patients after intensive care. Anaesthesia 2001; 56: 841–6.
Tablice umrljivosti prebivalstva Slovenije 2003–2004. Ljubljana: Statistični urad Republike Slovenije; 2005.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: A severity of disease classification system. Crit Care Med 1985; 13: 818–29.
Herridge MS. Long-term outcomes after critical illness. Curr Opin Crit Care 2002; 8: 331–6.
Cuthbertson BH, Scott J, Strachan M, Kilonzo M, Vale L. Quality of life before and after intensive care. Anaesthesia 2005; 60: 332– 9.
Badia X, Diaz-Prieto A, Gorriz MT, Herdman M, Torrado H, Farrrero E, Cavanilles JM. Using the EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit. Intensive Care Med 2001; 27: 1901–7.
Kersnik J. Zadovoljstvo bolnikov z zdravnikom družinske medicine: primerjava med Evropo in Slovenijo. Zdrav Vestn 2000; 69: 5–10.
Granja C, Teixeira-Pinto A, Costa-pereira A. Quality of life after intensive care – evaluation with EQ-5D questionnaire. Intensive Care Med 2002; 28: 898–907.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
