Jiang Weilin, Ni Qiqi, Zhang Chuchu, Dong Yuheng, Yi Jia, Yan Ran, Huang Zhenzhen, Wang Li, Sui Weijing, Gong Xiaoyan, Zhuang Yiyu
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Crit Care Med. 2025 Sep 1;53(9):e1803-e1814. doi: 10.1097/CCM.0000000000006770. Epub 2025 Jul 15.
The factors influencing quality of life (QOL) after intensive care are diverse and complex, and the QOL levels remain unclear. This systematic review and meta-analysis aimed to identify the factors influencing QOL and QOL levels in post-ICU patients.
We searched eight databases: PubMed, Embase, EBSCOhost, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WeiPu, and WanFang, from inception to October 15, 2024.
We included observational studies that examined factors influencing QOL in post-ICU patients.
Two independent reviewers extracted and recorded the data.
A total of 65 studies, encompassing 17,298 post-ICU patients, met the inclusion criteria. The key pre-ICU factors are advanced age (per 1-yr increase) (β: -0.045 [95% CI, -0.057 to -0.033]) and female gender (odds ratio: 1.104 (95% CI, 1.035-1.177]). The key intra-ICU factors are length of ICU stay (per 1-d increase) (β: -0.012 [95% CI, -0.019 to -0.005]), length of mechanical ventilation (per 1-d increase) (β: -0.005 [95% CI, -0.009 to -0.001]), and length of hospital stay (per 1-d increase) (β: -0.107 [95% CI, -0.161 to -0.054]). The pooled overall QOL score was 58.835 (95% CI, 52.935-64.735), the pooled physical component summary (PCS) score was 49.517 (95% CI, 45.781-53.253), the pooled mental component summary (MCS) score was 53.509 (95% CI, 50.301-56.718), and the pooled overall QOL index was 0.750 (95% CI, 0.713-0.787).
Most pre-ICU and intra-ICU factors demonstrated strong associations with post-ICU QOL. The QOL in post-ICU patients remains at a moderate level, with the PCS score indicating greater impairment than the MCS score. Further research is highly recommended to explore effective intervention strategies to improve QOL in post-ICU patients, particularly concerning their physical well-being.
重症监护后影响生活质量（QOL）的因素多样且复杂，生活质量水平仍不明确。本系统评价和荟萃分析旨在确定影响重症监护病房（ICU）后患者生活质量及其水平的因素。
我们检索了8个数据库：PubMed、Embase、EBSCOhost、Cochrane图书馆、科学网、中国知网、维普和万方，检索时间从建库至2024年10月15日。
我们纳入了检查影响ICU后患者生活质量因素的观察性研究。
两名独立的审阅者提取并记录数据。
共有65项研究符合纳入标准，涉及17298例ICU后患者。ICU前的关键因素是高龄（每增加1岁）（β：-0.045 [95%置信区间，-0.057至-0.033]）和女性（优势比：1.104 [95%置信区间，1.035 - 1.177]）。ICU内的关键因素是ICU住院时间（每增加1天）（β：-0.012 [95%置信区间，-0.019至-0.005]）、机械通气时间（每增加1天）（β：-0.005 [95%置信区间，-0.009至-0.001]）和住院时间（每增加1天）（β：-0.107 [95%置信区间，-0.161至-0.054]）。汇总的总体生活质量评分为58.835（95%置信区间，52.935 - 64.735），汇总的身体成分总结（PCS）评分为49.517（95%置信区间，45.781 - 53.253），汇总的心理成分总结（MCS）评分为53.509（95%置信区间，50.301 - 56.718），汇总的总体生活质量指数为0.750（95%置信区间，0.713 - 0.787）。
大多数ICU前和ICU内因素与ICU后生活质量密切相关。ICU后患者的生活质量仍处于中等水平，PCS评分表明身体功能受损程度大于MCS评分。强烈建议进一步研究探索有效的干预策略，以改善ICU后患者的生活质量，特别是关于他们的身体健康。
