FACTORS RELATED TO QUALITY-OF-LIFE 12 MONTHS AFTER DISCHARGE FROM AN INTENSIVE-CARE UNIT

Objective: To perform an analysis of the quality of life of survivors after ICU discharge. Design: Prospective study. Setting: Medical-surgical ICU of a Spanish reference hospital. Patients: Patients (n = 606) admitted in a 6-month period. Method: A questionnaire regarding quality of life issues was completed at the time of admission by patients or surrogates (n = 606). The questionnaire was given again 12 months after ICU discharge to 444 surviving patients. Both questionnaires evaluated the patient's ability to function and communicate for the previous 3 months. A Quality of Life score of 0 corresponded to no limitations. An increasing score indicated a reduction in function. A score of > 10 points implied a severe physical handicap. Information was also collected on the severity of illness and the diagnosis that prompted ICU admission. Results: The mean Quality of Life score of all survivors worsened from a mean of 4.62 at the time of ICU admission to a mean of 6.11 at 12 months after ICU discharge (p < .01) and was most evident for patients >75 yrs of age (from a mean of 6.33 to a mean of 9.54). However, patients with the highest initial Quality of Life scores had a significant improvement at 12 months (14.61 +/- 0.50 to 12.48 +/- 0.78 points [p < .05]). A higher severity of illness score corresponded to a higher Quality of Life score, but a multivariate analysis indicated that the factors with the greatest influence on the post-discharge Quality of Life score were the initial Quality of Life score and age. Conclusions: Twelve months after discharge from the ICU, a patient's functional status, as measured by the Quality of Life score, is influenced most by age and their Quality of Life score at the time of ICU admission. While there is an overall decrease in the Quality of Life score for survivors, admission and treatment in an ICU do not always result in deterioration of the Quality of Life score. This study indicates that Quality of Life scores could become a routine part of patient evaluation.