Changes in health-related quality of life and factors predicting long-term outcomes in older adults admitted to intensive care units*

Abstract

One-third of adults 65 yrs old and older admitted to the intensive care unit die within 6 months of hospital discharge. Among survivors at 6 months, health-related quality of life has significantly worsened over time in the oldest patients but improved in the youngest. Our study in a large cohort of mixed intensive care unit patients identifies additional prognostic factors and significant quality of life information in intensive care unit survivors well after hospital discharge. This additional information may guide clinicians in their discussions with patients, families, and other providers as they decide on what treatments and interventions to pursue.

Delirium in critically ill patients

“…It appears plausible that the results would have been different if we would have also measured them in an earlier stage after discharge. Khouli et al (39) showed that a higher proportion of older patients died within 6 months after ICU discharge, and the HRQoL worsened after 6 months in the oldest group but improved in the younger group. However, taking into account the fact that cognitive impairment improved in delirium patients between 3 and 12 months after ICU discharge (6), differences between the delirium and nondelirium ICU survivors in our group was probably more pronounced earlier in the course of recovery.…”

Quality of life after mild to moderate trauma

“…We decided to perform an adjunctive analysis to evaluate prognostic role of HRQOL before the event, an element that has not been taken into account by previous papers [24][25][26] which performed a similar analysis. Most of our patients showed normal scores before the trauma; compared with patients who maintained a normal HRQOL, patients who developed an HRQOL worsening showed lower but normal PCS and MCS scores.…”

An Exploratory Study of Long-Term Outcome Measures in Critical Illness Survivors: Construct Validity of Physical Activity, Frailty, and Health-Related Quality of Life Measures*

“…Domain scores and component summary scores were also compared with normbased control scores (mean, 50; sd, 10) provided by inbuilt algorithms (17). Comparison to population norms is standard for ICU follow-up studies using SF-36 scoring (2,5,6).…”

“…Such survivor disability has been assessed using objective (2,3) and subjective (4) tools, with subjective questionnairebased self-reporting (2,5,6) being commonly used. Healthrelated quality of life (HRQL) questionnaires have generally been employed as the default for long-term physical, psychological, and cognitive outcomes in survivors of critical illness.…”