Konopad E, Noseworthy T W, Johnston R, Shustack A, Grace M
Department of Adult Intensive Care, Royal Alexandra Hospital, Edmonton, AB, Canada.
Crit Care Med. 1995 Oct;23(10):1653-9. doi: 10.1097/00003246-199510000-00008.
To assess outcome of patients admitted to an intensive care unit (ICU), using a prospective 1-yr follow-up, with special emphasis on various quality of life measures before and after admission to the ICU.
Prospective comparison of quality of life before and 1 yr after admission to the ICU.
Eleven-bed adult medical/surgical ICU.
All patients admitted to the ICU over a 1-yr period were eligible for inclusion in this study. Repeat admissions were enrolled only on first admission. Patients < 17 yrs of age and those patients who died within 24 hrs of admission were excluded.
Quality of life measures were collected before and 6 and 12 months after ICU admission.
The following data were collected: duration of ICU and hospital stay; ICU, hospital, 6- and 12-month mortality; quality of life (level of activity, activities of daily living, perceived health, support, and outlook on life) and place of residence at baseline and 12 months after ICU admission. There were 504 patients who met the study criteria; age 55 +/- 20 yrs (median 59), 229 female and 275 male. Mean ICU length of stay was 4.3 +/- 7.4 days. Hospital length of stay was 31 +/- 41 days. Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 14 +/- 7. Cumulative mortality: ICU 5.4%, hospital 13.5%, 6 month 20.6%, and 12 month 25%. One year quality of life questionnaires were completed for 293 patients. Relative to baseline, there was a decrease in the level of activity and activities of daily living at 12 months (p < .01). Perceived health status increased over the year for patients > or = 75 yrs of age (p < .01). There was no difference in the level of support from family or friends, or outlook on life, at 12 months. At 1 yr, 262 (89%) patients were living at home.
Patients admitted to intensive care tend to have a decrease in the level of activity and activities of daily living 1 yr after their ICU stay, although in the very elderly, perceived health status increases. As well, the majority (89%) of patients return home.
通过为期1年的前瞻性随访，评估入住重症监护病房（ICU）患者的预后，特别关注入住ICU前后的各种生活质量指标。
对入住ICU前和入住后1年的生活质量进行前瞻性比较。
拥有11张床位的成人内科/外科ICU。
在1年期间入住该ICU的所有患者均符合纳入本研究的条件。重复入院患者仅纳入首次入院时的情况。排除年龄<17岁的患者以及入院后24小时内死亡的患者。
在入住ICU前、入住后6个月和12个月收集生活质量指标。
收集了以下数据：ICU住院时间和住院总时长；ICU、医院、6个月和12个月时的死亡率；生活质量（活动水平、日常生活活动能力、自我感知健康状况、支持情况以及生活态度）以及入住ICU前基线时和入住后12个月的居住地点。共有504名患者符合研究标准；年龄55±20岁（中位数59岁），女性229名，男性275名。ICU平均住院时间为4.3±7.4天。住院总时长为31±41天。急性生理与慢性健康状况评估II（APACHE II）评分为14±7。累积死亡率：ICU为5.4%，医院为13.5%，6个月时为20.6%，12个月时为25%。293名患者完成了1年的生活质量问卷调查。与基线相比，12个月时活动水平和日常生活活动能力有所下降（p<.01）。75岁及以上患者的自我感知健康状况在这一年有所改善（p<.01）。12个月时，来自家人或朋友的支持水平以及生活态度没有差异。1年后，262名（89%）患者在家中生活。
入住重症监护病房的患者在ICU住院1年后，其活动水平和日常生活活动能力往往会下降，不过在高龄患者中，自我感知健康状况有所改善。此外，大多数（89%）患者回家生活。
