Quality of life measures before and one year after admission to an intensive care unit

Konopad, Elsie; Noseworthy, Thomas; Johnston, Richard; Shustack, Allan; Grace, Michael

doi:10.1097/00003246-199510000-00008

Cited by 136 publications

(68 citation statements)

References 14 publications

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“…This is consistent with other studies [5,6] where hospital mortality rates have been found to be twice the ICU mortality. When making the decision whether to admit a patient to ICU, it is important to consider hospital mortality as well as ICU outcomes.…”

Section: Discussionsupporting

confidence: 93%

“…Significant variations have been found in ICU use by hospital characteristics and geographical location that remained significant after controlling for severity of illness and patient demographic characteristics [4]. In addition, studies show that hospital mortality rates were as high as twice ICU mortality rates [5,6]. It is clear that a contemporary survey of current practice as regards ICU admission and outcome in HIV-positive patients was warranted.…”

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confidence: 99%

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ICU admission in patients infected with the human immunodeficiency virus — a multicentre survey

et al. 1999

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We conducted a retrospective study to assess the reasons for admission to the intensive care unit, and subsequent outcome, in patients infected with the human immunodeficiency virus (HIV). Four hospitals in the south of England participated, all with specialist HIV units. Data were collected on 127 patients admitted to ICU on 133 separate occasions between June 1993 and October 1997. The mean age on admission was 38 years (range 23–60 years). Ninety‐four patients (70.7%) were documented HIV‐positive before admission and 36 (27%) were diagnosed HIV‐positive for the first time during admission; 36.1% were admitted with Pneumocystis carinii pneumonia. Overall ICU mortality was 33%, in‐hospital mortality was 56% and the eventual mortality at the end of follow‐up (March 1998) was 72%. Survival was highest in those admitted with respiratory HIV‐related disease or HIV‐unrelated illness. Associations with poor outcome included a prior AIDS‐defining illness, a CD4 cell count of less than 100 cells.ml−1 and admission secondary to sepsis.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

ICU admission in patients infected with the human immunodeficiency virus — a multicentre survey

et al. 1999

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“…Even though mortality as an outcome measure has often been challenged [9], this measure remains one of the key parameters. The reasons are the simplicity of its definition and the ease of obtaining results (at least with respect to ICU or hospital mortality).…”

Section: Introductionmentioning

confidence: 99%

Intensive care 1980–1995: change in patient characteristics, nursing workload and outcome

1997

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Objective: To assess temporal changes in patient characteristics, nursing workload and outcome of the patients and to compare the actual amount of available nursing staff with the estimated needs in a medical-surgical ICU. Design: Retrospective analysis of prospectively collected data. Setting: A medical-surgical adult intensive care unit (ICU) in a Swiss university hospital. Patients: Data of all patients staying in the ICU between January 1980 and December 1995 were included. Interventions: None. Measurements and results:The estimated number of nurses needed was defined according to the Swiss Society of Intensive Care Medicine (SGI) grading system: category I = one nurse/patient/shift ( = 8 h), category II = one nurse/two patients/shift, category III= one nurse/ three patients/shift. An intervention score (IS) was obtained, based on a number of specific activities in the ICU. There was a total of 35,327 patients (32 % medical and 68 % postoperative/trauma patients). Over time, the number of patients per year increased (1980/1995: 1,825/2,305, p < 0.001) and the length of ICU stay (LOS) decreased (4.1/3.8 days, p < 0.013). There was an increase in the number of patients aged > 70 years (19 %/28 %, p < 0.001), and a decrease in the number of patients < 60 years (58 %/41%, p < 0.001). During the same time period, the IS increased two-fold. Measurement of nursing workload showed an increase over time. The number of nursing days per year increased (1980/1995: 7454/8681, p < 0.019), as did the relative amount of patients in category I (49 %/71%,p < 0.001), whereas the portion of patients in category II (41%/28 %, p < 0.019) and category III (10 %/0 %) decreased. During the same time period, mortality at ICU discharge decreased (9.0 %/ 7.0 %, p < 0.002). Conclusions: During the last 16 years, there has been a marked increase in workload at this medicalsurgical ICU. Despite an increase in the number of severely sick patients (as defined by the nursing grading system) and patient age, ICU mortality and LOS declined from 1980 to 1995. This may be ascribed to improved patient treatment or care. Whether an increasingly liberal discharge policy (transfer to newly opened intermediate care units, transfer of patients expected to die to the ward) or a more rigorous triage (denying admission to patients with a very poor prognosis) are confounding factors cannot be answered by this investigation. The present data provide support for the tenet that there is a trend toward more complex therapies in increasingly older patients in tertiary 1166 care ICUs. Calculations for the number or nurses needed in an ICU should take into account the increased turnover of patients and the changing patient characteristics.

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“…[14][15][16][17][18] Further, it seems useful in predicting outcomes other than death, such as healthrelated quality of life and health services utilization. [19][20][21][22][23] Data about functional status and well-being are theoretically easy to obtain; one need only ask or observe. Most assessments can be made quickly and with a minimum of bother to patients.…”

mentioning

confidence: 99%

Health Status Assessment Completing the Clinical Database

1997

J Gen Intern Med

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Quality of life measures before and one year after admission to an intensive care unit

Abstract: Patients admitted to intensive care tend to have a decrease in the level of activity and activities of daily living 1 yr after their ICU stay, although in the very elderly, perceived health status increases. As well, the majority (89%) of patients return home.

Cited by 136 publications

References 14 publications

ICU admission in patients infected with the human immunodeficiency virus — a multicentre survey

ICU admission in patients infected with the human immunodeficiency virus — a multicentre survey

Intensive care 1980–1995: change in patient characteristics, nursing workload and outcome

Health Status Assessment Completing the Clinical Database

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