Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.
Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
PLoS One. 2022 Sep 7;17(9):e0273348. doi: 10.1371/journal.pone.0273348. eCollection 2022.
More substantial information on recovery after Intensive Care Unit (ICU) admission is urgently needed. In a previous retrospective study, the proportion of non-recovery patients was 44%. The aim of this prospective follow-up study was to evaluate changes in Health-Related Quality of Life (HRQoL) in the first year after ICU-admission.
Long-stay adult ICU-patients (≥ 48 hours) were included. HRQoL was evaluated with the Dutch translation of the RAND-36 item Health Survey (RAND-36) at baseline via proxy measurement, and at three, six, and twelve months after ICU admission. Subsequently, the relation between physical functioning, healthcare utilisation, and work activities was explored.
A total of 81 patients were included in this study. Fifty-five percent of patients did not meet criteria for full recovery and were allocated to the Non Recovery (NR)-group (Physical Functioning domain-score: 35 [15-55]). Baseline physical HRQoL differed significantly between the Recovery (R) and NR-group. Patients in the NR-group received home care more often and had higher healthcare utilisation (44 versus 17% in the first three months post-ICU, p = 0.013). Only fourteen percent of NR-patients were able to participate in work activities. Moreover, NR-patients persistently showed impaired overall HRQoL throughout the year after critical illness.
Limited recovery in ICU survivors is reflected in overall impaired HRQoL, as well as in far-reaching consequences for patients' healthcare needs and their ability to reintegrate into society. In our study, baseline HRQoL appeared to be an important predictor of long-term outcomes, but not Clinical Frailty Scale (CFS) score. And, (proxy-derived) HRQoL may help to identify patients at risk of long-term non-recovery.
迫切需要更多关于重症监护病房（ICU）入院后康复的信息。在之前的回顾性研究中，非康复患者的比例为 44%。本前瞻性随访研究的目的是评估 ICU 入院后一年内健康相关生活质量（HRQoL）的变化。
纳入长期入住成人 ICU 的患者（≥48 小时）。通过代理测量，在基线时使用荷兰语翻译的 RAND-36 项健康调查（RAND-36）评估 HRQoL，并在 ICU 入院后 3、6 和 12 个月进行评估。随后，探讨了身体功能、医疗保健利用和工作活动之间的关系。
本研究共纳入 81 例患者。55%的患者不符合完全康复的标准，被分配到非康复（NR）组（身体功能域评分：35[15-55]）。NR 组和 R 组的基线身体 HRQoL 存在显著差异。NR 组患者更常接受家庭护理，医疗保健利用率更高（ICU 后前三个月分别为 44%和 17%，p=0.013）。只有 14%的 NR 患者能够参与工作活动。此外，NR 患者在重病后一年内整体 HRQoL 持续受损。
ICU 幸存者的康复受限反映在整体受损的 HRQoL 中，以及对患者医疗需求和重返社会能力的深远影响。在我们的研究中，基线 HRQoL 似乎是长期预后的重要预测因素，但不是临床虚弱量表（CFS）评分。并且，（代理衍生的）HRQoL 可能有助于识别有长期非康复风险的患者。
