Ortiz D, Galguera F, Jam M R, Vilar S, Castella X, Artigas A
Servicio de Medicina Intensiva, Corporación Sanitaria Parc Taulí Hospital General de Manresa.
Enferm Intensiva. 1998 Oct-Dec;9(4):141-50.
At present there is no single practical standardized scale for measuring quality of life (QL). Any proposal should include the patient's physical impairment, level of independence, and subjective perception of happiness. We combined three previously published scales to define a quality of life index (QLI) that we propose as a standard quantitative instrument. The applicability and usefulness of QLI for the measurement of the level of deterioration of patients after admission to an intensive care unit (ICU) was examined. We prospectively evaluated QL before patient admission to determine if it influences mortality, as well as long-term changes in the QL and the factors conditioning te deterioration of patients released from the UCI as evaluated by QL indicators.
To calculate QLI, we combined the Karnofsky scale, daily life activities index, and the perception of quality of life scale. The resulting percentage (QLI) was used to evaluate 536 patients after admission to the ICU and 6 and 12 months after release. QLI was compared with the severity of disease (Apache II), probability of death (MPM), diagnostic group, and socioeconomic variables.
Using multivariate methods, four significant variables related with mortality were identified: Apache II--MPM, duration of the stay in the unit, age, and QLI. Our analysis of long-term deterioration showed that advanced age, high QLI before admission, and the patient's diagnostic group explained the degree of deterioration.
QLI was a useful instrument for obtaining a quantitative estimate of the QL of critically ill patients.
目前尚无单一实用的标准化量表来衡量生活质量（QL）。任何提议都应涵盖患者的身体损伤、独立程度以及主观幸福感。我们结合了之前发表的三个量表来定义一个生活质量指数（QLI），并提议将其作为一种标准定量工具。我们研究了QLI在测量重症监护病房（ICU）患者入院后病情恶化程度方面的适用性和实用性。我们前瞻性地评估了患者入院前的QL，以确定其是否影响死亡率，以及QL的长期变化和通过QL指标评估的从ICU出院患者病情恶化的影响因素。
为计算QLI，我们结合了卡诺夫斯基量表、日常生活活动指数和生活质量感知量表。所得百分比（QLI）用于评估536例ICU入院患者以及出院后6个月和12个月的情况。将QLI与疾病严重程度（急性生理与慢性健康状况评分系统II [Apache II]）、死亡概率（多器官功能障碍综合征死亡概率模型 [MPM]）、诊断组和社会经济变量进行比较。
使用多变量方法，确定了与死亡率相关的四个显著变量：Apache II - MPM、在ICU的住院时间、年龄和QLI。我们对长期病情恶化的分析表明，高龄、入院前高QLI以及患者的诊断组解释了病情恶化程度。
QLI是一种用于对重症患者的QL进行定量评估的有用工具。
