Health-related quality of life in ICU survivors—10 years later

Abstract

Many Intensive Care (ICU) survivors experience long lasting impairments in physical and psychological health as well as social functioning. The objective of our study was to evaluate these effects up to 10 years after ICU discharge. We performed a long-term prospective cohort study in patients admitted for longer than 48 h in a medical-surgical ICU. We evaluated health-related quality of life (HRQOL) before ICU admission using the Short-form-36 (SF-36), at ICU discharge, at hospital discharge and at 1, 2, 5 and 10 years follow up (all by patients). Changes in HRQOL were assessed based on linear mixed modeling. We included a total of 749 patients (from 2000 to 2008). During 10 years 475 (63.4%) patients had died, 125 (16.7%) patients were lost to follow up and 149 (19.9%) patients could be evaluated. The mean scores of four HRQOL dimensions (i.e., physical functioning (p < 0.001; mean 54, SD 32, effect size 0.77, 95% CI [0.54–1.0]), role-physical (p < 0.001; mean 44, SD 47, effect size 0.65, 95% CI [0.41–0.68] general health (p < 0.001; mean 52, SD 27, effect size 0.48; 95% CI 0.25–0.71) and social functioning (p < 0.001; mean 72, SD 32, effect size 0.41, 95% CI [0.19–0.64]) were still lower 10 years after ICU discharge compared with pre-admission levels (n = 149) and with an age reference population. Almost all SF-36 dimensions changed significantly over time from ICU discharge up to 10 years after ICU discharge. Over the 10 year follow up physical functioning of medical-surgical ICU survivors remains impaired compared with their pre-admission values and an age reference population. However, effect sizes showed no significant differences suggesting that surviving patients largely regained their age-specific HRQOL at 10 years.

Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study

“…Finally, among ICU survivors significant modifications in HRQoL dimensions were reported up to ten years after discharge [42], therefore, longer follow-up times could help in better defining the HRQoL trajectories and the effects of eventual interventions [43].…”

Long-term health-related quality of life, healthcare utilisation and back-to-work activities in intensive care unit survivors: Prospective confirmatory study from the Frisian aftercare cohort

“…Results may not be identical in a different, for example academic or international, setting. Furthermore, the number of lost-to-follow-up has the potential to create unaccounted bias, although the percentage is lower than reported in previous literature on post-ICU follow-up services and research [ 4 ]. Moreover, as this study has a longer and more extensive follow-up than our regular specialised outpatient clinic, it is notable that the researchers managed to complete the follow up the majority of participants despite the ongoing COVID-19 pandemic.…”

Modelling the potential acute and post-acute burden of COVID-19 under the Australian border re-opening plan

“… 14 days to 2 years (assumed) 0.219 (0.148-0.308) [ 10 , 11 ] Post-Intensive Care Syndrome (PICS) 90.6% of ICU survivors [ 20 ] See notes below on how we compute for the COVID-19 survivors noted in this calculation. 14 days (to remaining lifetime expectancy) [ 21 , 22 ] 0.224 (0.151-0.312) a (a) [ 23 , 24 ] PICS Post Intensive Care Syndrome, NSW New South Wales, ONS Office of National Statistics, a Used in uncertainty analysis using beta-distribution; a Symptomatic atrial fibrillation and flutter as proxy for PICS, refer to Additional file 2 for the calculation …”

“…We selected atrial fibrillation and flutter which has a utility score of 0.75 [ 23 ] and a disability weight of 0.22 (95%CI: 0.15–0.31) [ 24 ]. A lifetime duration was assumed for PICS reflecting study findings that followed ICU survivors over 5-years and 10-years [ 21 , 22 ].…”