Graf Jürgen, Koch Mechthild, Dujardin Robert, Kersten Alexander, Janssens Uwe
Medical Clinic I, University Hospital Aachen, Germany.
Crit Care Med. 2003 Aug;31(8):2163-9. doi: 10.1097/01.CCM.0000079607.87009.3A.
Assessment of health-related quality of life before, 1 month after, and 9 months after an intensive care unit stay using an established generic instrument, the Medical Outcome Survey Short Form-36 (SF-36).
Prospective, observational study.
University hospital medical intensive care unit.
Two hundred forty-five patients with predominantly cardiovascular and pulmonary disorders.
None.
Demographic data, Simplified Acute Physiology Score (SAPS) II, and Sepsis-Related Organ Failure Assessment (SOFA) were obtained. All adult survivors staying in the intensive care unit for >24 hrs were eligible. Pre-intensive care unit status was obtained for 245 patients (179 males, mean age 64 yrs, mean intensive care unit stay 3 days, SAPS II 26 +/- 10), and 153 patients completed all three questionnaires. In this cohort, none of the eight health dimensions of the SF-36 showed impaired functioning after 9 months compared with baseline values. Physical and emotional role deteriorated after 1 month but returned to baseline thereafter. Notably, the mental health summary scale did not change during the course of the study, whereas the physical health summary scale consistently improved over time. Patients older than the median of 66 yrs rated their physical functioning lower. No association with SAPS II or SOFA and SF-36 was found.
Quality of life after intensive care unit is a dynamic process, with some functions improving shortly after intensive care unit discharge and others deteriorating but returning at least to baseline values later on. In this patient population, the SF-36 was independent from measures of severity of illness or morbidity. Health-related quality of life represents a feasible method to collect patients' individual views in contrast to surrogate measures of outcome.
使用已确立的通用工具——医学结果调查简表-36（SF-36），评估重症监护病房住院前、住院后1个月和住院后9个月的健康相关生活质量。
前瞻性观察性研究。
大学医院医学重症监护病房。
245例主要患有心血管和肺部疾病的患者。
无。
获取人口统计学数据、简化急性生理学评分（SAPS）II和脓毒症相关器官功能衰竭评估（SOFA）。所有在重症监护病房住院超过24小时的成年幸存者均符合条件。获取了245例患者（179例男性，平均年龄64岁，平均重症监护病房住院时间3天，SAPS II为26±10）的重症监护病房住院前状况，153例患者完成了全部三份问卷。在该队列中，与基线值相比，9个月后SF-36的八个健康维度均未显示功能受损。身体和情感角色在1个月后恶化，但随后恢复到基线水平。值得注意的是，心理健康总结量表在研究过程中没有变化，而身体健康总结量表随时间持续改善。年龄大于中位数66岁的患者对其身体功能的评分较低。未发现SAPS II或SOFA与SF-36之间存在关联。
重症监护病房后的生活质量是一个动态过程，一些功能在重症监护病房出院后不久有所改善，另一些功能则恶化，但随后至少恢复到基线值。在该患者群体中，SF-36独立于疾病严重程度或发病率的测量指标。与替代结局指标相比，健康相关生活质量是收集患者个人观点的一种可行方法。
