Quality of life six years after intensive care.

OBJECTIVE

To assess the degree of change in long-term quality of life (QOL) in critically ill patients 1 and 6 years after discharge from the intensive care unit (ICU).

DESIGN

Prospective observational study.

SETTING

A ten-bed medical-surgical ICU in a tertiary care hospital.

PATIENTS

Of the 591 consecutive patients admitted in 1995 the study comprised those 169 who responded to both QOL questionnaires, sent in 1996 and 2001.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

A generic scale assessing health-related QOL, the RAND 36, sent by mail. Six years after discharge 9% of the patients considered their present health status as excellent, 37% as good, 45% as satisfactory and 9% as poor. The absolute values of the different QOL domains revealed worse physical functioning ( p<0.001), pain ( p=0.008) and general health ( p=0.012), but less emotional role limitation ( p=0.006) as compared with the 1996 values. Compared with the age- and gender-matched general population (controls), a marked improvement was detected in physical and emotional role limitations, and in vitality. However, 6 years after ICU discharge pain was worse, and physical functioning and general health were still reduced as compared with controls.

CONCLUSIONS

When evaluating the long-term outcome of ICU patients, the timing of QOL assessment is essential; especially the emotional domains seem to improve slowly. Further studies focusing on the effect of time on various QOL domains and the predictive factors for a long-term QOL are therefore warranted.