Symptom burden and health-related quality of life among intensive care unit survivors in Argentina: A prospective cohort study

• Published in: Journal of critical care Vol. 30; no. 5; pp. 1049 - 1054
• Main Authors: Das Neves, Andrea V., MD, Vasquez, Daniela N., MD, Loudet, Cecilia I., MD, Intile, Dante, MD, Sáenz, María Gabriela, MD, Marchena, Cecilia, MD, Gonzalez, Ana L., MD, Moreira, Joaquin, MD, Reina, Rosa, MD, Estenssoro, Elisa, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2015; Elsevier Limited
• Subjects: Adult; Argentina; Brain Injuries - psychology; Confidence intervals; Cost of Illness; Critical Care; Critical Illness - therapy; EuroQol-5D; Expected values; Female; Hospitalization; Hospitals; HRQOL; Humans; Illnesses; Intensive care; Intensive Care Units; Interviews; Male; Mechanical ventilation duration; Middle Aged; Mortality; Multivariate analysis; Ostomy; Patient Discharge; Patients; Physiology; Prospective Studies; Quality of Life; Rehabilitation; Respiration, Artificial; Respiratory distress syndrome; Studies; Surgery; Surveys and Questionnaires; Survivors; Traumatic brain injury sequelae; Urine; Variables; Weakness; Young Adult; Critical care; Mechanical ventilation duration; HRQOL; EuroQol-5D; Traumatic brain injury sequelae; Weakness
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2015.05.021

Abstract Purpose Our goal was to describe the evolution of selected physical and psychologic symptoms and identify the determinants of health-related quality of life (HRQOL) after intensive care unit (ICU) discharge. Methods The study is a prospective cohort of consecutive adult patients admitted to a mixed ICU in a university-affiliated hospital, mechanically ventilated for more than 48 hours. During ICU stay, epidemiological data and events probably associated to worsening outcomes were recorded. After discharge, patients were interviewed at 1, 3, 6, and 12 months. Health-related quality of life was assessed with EuroQoL Questionnaire–5 Dimensions, which includes the EQ-index and EQ–Visual Analogue Scale. Results One hundred twelve patients were followed up, aged 33 [24-49] years, 68% male, 76% previously healthy, and cranial trauma was the main diagnosis. Physical and psychologic symptoms and moderate/severe problems according to the EQ index progressively decreased after discharge, yet were still highly prevalent after 1 year. EQ index improved from 0.22 [0.01-0.69] to 0.52 [0.08-0.81], 0.66 [0.17-0.79], and 0.68 [0.26-0.86] ( P < .001, for all vs month 1). EQ–Visual Analogue Scale remained stable, within acceptable values. Independent determinants of EQ-index were time, duration of mechanical ventilation, shock, weakness, and return to study/work. Conclusions Determinants of HRQOL after ICU discharge were both related to late sequelae of critical illness and to some events occurring in the ICU. Notwithstanding the high symptom burden, patients still perceived their HRQOL as good.