Long-term Quality of Life After Intensive Care Unit Admission (a Single-Center Observational Study)

Abstract

Patients may experience long-term physical, psychological and cognitive impairment after intensive care unit (ICU) discharge, a condition commonly described as post-intensive care syndrome. The relative contribution of each of these components to long-term quality of life was never investigated.The aim of this study is to identify the type and severity of disability and QoL at the discharge from ICU and up to following 6 months.Material and Methods. All patients (n=218) discharged from a university hospital ICU between April 2016 and July 2017 were eligible. Exclusion criteria included: age <18 years, brain or spinal injury, life expectancy <90 days, and ICU stay <12 hours. The Short Form Health Survey (SF-36), and 5-level EuroQoL-5D (EQ-5D-5L) questionnaires were administered at ICU discharge, and at 30-, 90- and 180-days. We compared patients requiring short-term ICU monitoring (IM, Intensive Monitoring, n=109) or patients requiring ICU treatment (IT, Intensive Treatment, n=109).Results. All dimensions of SF-36 and EQ-5D-5L parameters increased from ICU discharge to 180-days, except for the SF-36 Synthetic index linked to mental health (P=0.08). All EQ-5D-5L parameters improved significantly in the IT group, while only Visual Analog Scale Health Perception improved in the IM group.Conclusion. ICU survivors suffer long-term physical and psychological sequelae. The perception of Quality of Life is reduced after ICU discharge. The psychological and cognitive dimensions were more compromised than physical ones. Patients discharged from the ICU may benefit from specific intensive care follow-up clinics addressing their needs in term of psychological and cognitive support.

One-Year Multidisciplinary Follow-Up of Patients With COVID-19 Requiring Invasive Mechanical Ventilation

“…15 Furthermore, our study suggests that post-ICU multidisciplinary follow-up for critically ill patients may have an important role for long-term outcomes. 14,57 The CDC (Centers for Disease Control and Prevention), together with the US Department of Human Health Services, rise the attention over the post-COVID conditions, now classified as a disease according to the Americans with Disabilities Act (ADA). 58 This post-viral syndrome, is defined as "persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms".…”

“…62 It is possible that the relatively young age of our patients and the prevalence of males, 63 led to better recovery from critical illness. Furthermore, symptoms of post-intensive care syndrome have been shown to improve over time 14 , and is possible that our dedicated post-COVID-19 followup clinic helped in subsequent recovery. 57,64,65 Notably, in a 6-month post discharge assessment of COVID-19 patients, female, compared to men, were found to have an OR 2.22 (95% CI 1.24-3.89) for pulmonary diffusion impairment, an OR 1.8 (CI 1.39-2.34) for anxiety and depression, an OR 1.33 (CI 1.05-1.67) for fatigue and muscle weakness.…”

“…[5][6][7][8] A similar pattern has been described for other respiratory coronaviruses infections (SARS-CoV-1 and Middle East Respiratory Syndrome [MERS]) as well as for the general ICU population. [9][10][11][12][13][14] Short-term mortality rate for COVID-19-related ARDS requiring invasive mechanical ventilation is around 50 %, 3,15 . However, data on long-term mortality and quality of life in this setting are scarce.…”