Schädler D, Kaiser L, Malchow B, Becher T, Elke G, Frerichs I, Küchler T, Weiler N
Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus 12, 24105, Kiel, Deutschland.
Zentrum für Lebensqualität, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland.
Anaesthesist. 2017 Apr;66(4):240-248. doi: 10.1007/s00101-017-0276-6. Epub 2017 Feb 7.
It is unknown whether health related quality of life measured in German patients one year after mechanical ventilation in the intensive care unit is impaired or not.
The aim of this study was to assess health related quality of life one year after inclusion into a randomized controlled trial for weaning from mechanical ventilation with the help of a questionnaire that has never been used in critically ill patients and to investigate whether health related quality of life scores differ between the study population and a general German population.
We followed up with patients one year after inclusion into a randomized control trial investigating the effect of SmartCare/PS on total ventilation time compared to protocol-driven weaning (ASOPI trial, clinicaltrials.gov ID00445289). Health related quality of life was measured using the quality of life questionnaire C‑30 version 3.0 from the European Organization of Research and Treatment of Cancer (EORTC). Mean differences of at least 10 score points in the quality of life scales were considered clinically significant.
Of the 232 patients who were alive 90 days after study inclusion, 24 patients died one year after study inclusion and 64 patients were lost to follow-up. Of the remaining145 patients who were successfully contacted, 126 patients agreed to fill out the questionnaire. Questionnaires were sent back to the study site by 83 patients and these were analyzed. Health-related quality of life was significantly lower in five of the six functional scales (physical functioning, role functioning, cognitive functioning, social functioning, global health status) and in eight of the nine symptom scales (fatigue, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties) compared to the reference values of a German normal population.
The EORTC QLQ-C30 questionnaire is suitable for the acquisition of the health-related quality of life in formerly critically ill patients. Health-related quality of life is severely impaired after mechanical ventilation in the intensive care unit. Future studies should consider health related quality of life as a possible study endpoint.
在重症监护病房接受机械通气一年后的德国患者中，其健康相关生活质量是否受损尚不清楚。
本研究的目的是借助一份从未在危重症患者中使用过的问卷，评估纳入机械通气撤机随机对照试验一年后的健康相关生活质量，并调查研究人群与德国普通人群的健康相关生活质量得分是否存在差异。
在一项随机对照试验纳入患者一年后进行随访，该试验研究SmartCare/PS与方案驱动撤机相比对总通气时间的影响（ASOPI试验，clinicaltrials.gov编号00445289）。使用欧洲癌症研究与治疗组织（EORTC）的生活质量问卷C-30第3.0版测量健康相关生活质量。生活质量量表中至少10分的平均差异被认为具有临床意义。
在纳入研究90天后仍存活的232例患者中，24例在纳入研究一年后死亡，64例失访。在成功联系到的其余145例患者中，126例同意填写问卷。83例患者将问卷寄回研究地点并进行了分析。与德国正常人群的参考值相比，六个功能量表（身体功能、角色功能、认知功能、社会功能、总体健康状况）中的五个以及九个症状量表（疲劳、疼痛、呼吸困难、失眠、食欲减退、便秘、腹泻、经济困难）中的八个，健康相关生活质量显著较低。
EORTC QLQ-C30问卷适用于获取既往危重症患者的健康相关生活质量。重症监护病房机械通气后，健康相关生活质量严重受损。未来的研究应将健康相关生活质量作为一个可能的研究终点。
