Intensive Care Medicine

, Volume 29, Issue 12, pp 2149–2156

Follow-up after intensive care: a single center study




To study health problems, quality of life, functional status, and memory after intensive care.


Adult patients (n=346) discharged from a university hospital ICU.

Design and methods

Prospective cohort study. Follow-up patients were found using the ICU database and the Peoples Registry. Quality of life (QOL) was measured with the Short Form 36 (SF-36) 6 months after ICU discharge. Semi-structured interviews, questionnaires, Glasgow Outcome Score (recovery), and Karnofsky Index (functional status) were used at consultations 7–8 months after ICU discharge.


The SF-36 response rate was 64.5%, with scores significantly lower than population scores. Consultation patients (n=136) did not differ from the rest (n=210) regarding age, SAPS II scores, length of stay (LOS), and reasons for ICU admission. At follow-up 67.6% of consultation patients continued most activities, 75% looked after themselves, and 64.7% were non-workers, compared to 40.4% before the ICU admission. During and after the ICU stay, 40% lost more than 10 kg body weight. Fifty-eight (43%) could not remember anything from their ICU stay. At follow-up only 22 (16%) could remember having received information during their ICU stay. Three patients needed referral to other specialities.


We should focus more on optimizing symptom management and giving repeated information after ICU discharge. Nutritional status and weight loss is another area of concern. More research is needed to find out how the broad range of psychosocial and physical problems following an ICU stay relates to the stay.


Intensive care Follow-up studies Patient outcome assessment Quality of life Health status Memory 


  1. 1.
    Eddleston JM, White P, Guthrie E (2000) Survival, morbidity, and quality of life after discharge from intensive care. Crit Care Med 28:2293–2299Google Scholar
  2. 2.
    Hurel D, Loirat P, Saulnier F, Nicolas F, Brivet F (1997) Quality of life 6 months after intensive care: results of a prospective multicenter study using a generic health status scale and a satisfaction scale. Intensive Care Med 23:331–337CrossRefGoogle Scholar
  3. 3.
    Konopad E, Noseworthy TW, Johnston R, Shustack A, Grace M (1995) Quality of life measures before and one year after admission to an intensive care unit. Crit Care Med 23:1653–1659Google Scholar
  4. 4.
    Black NA, Jenkinson C, Hayes JA, Young D, Vella K, Rowan KM, Daly K, Ridley S (2001) Review of outcome measures used in adult critical care. Crit Care Med 29:2119–2124PubMedGoogle Scholar
  5. 5.
    Vazquez Mata G, Rivera Fernandez R, Gonzalez Carmona A, Delgado-Rodriguez M, Torres Ruiz JM, Raya Pugnaire A, Aguayo de Hoyos E (1992) Factors related to quality of life 12 months after discharge from an intensive care unit. Crit Care Med 20:1257–1262PubMedGoogle Scholar
  6. 6.
    Wehler M, Martus P, Geise A, Bost A, Mueller A, Hahn EG, Strauss R (2001) Changes in quality of life after medical intensive care. Intensive Care Med 27:154–159CrossRefPubMedGoogle Scholar
  7. 7.
    Broomhead LR, Brett SJ (2002) Clinical review: Intensive care follow-up—what has it told us? Critical Care 6:411–417CrossRefPubMedGoogle Scholar
  8. 8.
    Rundshagen I, Schnabel K, Wegner C, am Esch S (2002) Incidence of recall, nightmares, and hallucinations during analgosedation in intensive care. Intensive Care Med 28:38–43CrossRefPubMedGoogle Scholar
  9. 9.
    Stein-Parbury J, McKinley S (2000) Patients’ experiences of being in an intensive care unit: a select literature review. Am J Crit Care 9:20–27PubMedGoogle Scholar
  10. 10.
    Rotondi AJ, Chelluri L, Sirio C, Mendelsohn A, Schulz R, Belle S, Im K, Donahoe M, Pinsky MR (2002) Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit Care Med 30:746–752PubMedGoogle Scholar
  11. 11.
    Jones C, Griffiths RD, Humphris G (2000) Disturbed memory and amnesia related to intensive care. Memory 8:79–94CrossRefPubMedGoogle Scholar
  12. 12.
    Jones C, Griffiths RD, Humphris G, Skirrow PM (2001) Memory, delusions, and the development of acute posttraumatic stress disorder-related symptoms after intensive care. Crit Care Med 29:573–580PubMedGoogle Scholar
  13. 13.
    Hupcey JE, Zimmerman HE (2000) The need to know: experiences of critically ill patients. Am J Crit Care 9:192–198PubMedGoogle Scholar
  14. 14.
    Griffiths RD, Jones C (2002) Intensive care aftercare. Butterworth Heinemann, Oxford, pp 1–170Google Scholar
  15. 15.
    Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164PubMedGoogle Scholar
  16. 16.
    Ware J (1993) SF-36 Health Survey. Manual and interpretation guide. The health institute, Boston, Mass., USAGoogle Scholar
  17. 17.
    Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. Lancet 1:480–484PubMedGoogle Scholar
  18. 18.
    Schag CC, Heinrich RL, Ganz PA (1984) Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol 2:187–193Google Scholar
  19. 19.
    Cytel Software Corporation StatXact. Cambridge SC, USA, 1999Google Scholar
  20. 20.
    Dragsted L, Qvist J, Madsen M (1990) Outcome from intensive care. IV. A 5-year study of 1308 patients: long-term outcome. Eur J Anaesthesiol 7:51–62Google Scholar
  21. 21.
    Niskanen M, Kari A, Halonen P (1996) Five-year survival after intensive care—comparison of 12,180 patients with the general population. Finnish ICU Study Group. Crit Care Med 24:1962–1967PubMedGoogle Scholar
  22. 22.
    Zaren B, Bergstrom R (1989) Survival compared to the general population and changes in health status among intensive care patients. Acta Anaesthesiol Scand 33:6–12Google Scholar
  23. 23.
    Flaatten H, Kvale R (2001) Survival and quality of life 12 years after ICU. A comparison with the general Norwegian population. Intensive Care Med 27:1005–10011PubMedGoogle Scholar
  24. 24.
    Ridley S, Plenderleith L (1994) Survival after intensive care. Comparison with a matched normal population as an indicator of effectiveness. Anaesthesia 49:933–935PubMedGoogle Scholar
  25. 25.
    Ridley SA, Chrispin PS, Scotton H, Rogers J, Lloyd D(1997) Changes in quality of life after intensive care: comparison with normal data. Anaesthesia 52:195–202PubMedGoogle Scholar
  26. 26.
    Chrispin PS, Scotton H, Rogers J, Lloyd D, Ridley SA (1997) Short Form 36 in the intensive care unit: assessment of acceptability, reliability and validity of the questionnaire. Anaesthesia 52:15–23PubMedGoogle Scholar
  27. 27.
    Loge JH, Kaasa S (1998) Short form 36 (SF-36) health survey: normative data from the general Norwegian population. Scand J Soc Med 26:250–258PubMedGoogle Scholar
  28. 28.
    Brooks R, Kerridge R, Hillman K, Bauman A, Daffurn K (1997) Quality of life outcomes after intensive care. Comparison with a community group. Intensive Care Med 23:581–586CrossRefPubMedGoogle Scholar
  29. 29.
    Holbrook TL, Anderson JP, Sieber WJ, Browner D, Hoyt DB (1999) Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project. J Trauma 46:765–773PubMedGoogle Scholar
  30. 30.
    Pettila V, Kaarlola A, Makelainen A (2000) Health-related quality of life of multiple organ dysfunction patients one year after intensive care. Intensive Care Med 26:1473–1479PubMedGoogle Scholar
  31. 31.
    Chaboyer W,Foster M, Creamer J (2002) Health status of ICU survivors: a pilot study. Aust Crit Care 15:21–26PubMedGoogle Scholar
  32. 32.
    Zaren B, Hedstrand U (1987) Quality of life among long-term survivors of intensive care. Crit Care Med 15:743–747PubMedGoogle Scholar
  33. 33.
    Negro F, Cerra FB (1988) Nutritional monitoring in the ICU: rational and practical application. Crit Care Clin 4:559–572PubMedGoogle Scholar
  34. 34.
    Griffiths RD, Jones C (1999) Recovery from intensive care. BMJ 319:427–429PubMedGoogle Scholar
  35. 35.
    Schelling G, Stoll C, Haller M, Briegel J, Manert W, Hummel T, Lenhart A, Heyduck M, Polasek J, Meier M, Preuss U, Bullinger M, Schuffel W, Peter K (1998) Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome. Crit Care Med 26:651–659Google Scholar
  36. 36.
    Scragg P, Jones A, Fauvel N (2001) Psychological problems following ICU treatment. Anaesthesia 56:9–14CrossRefPubMedGoogle Scholar
  37. 37.
    Jones C, Humphris GM, Griffiths RD (1998) Psychological morbidity following critical illness—the rationale for care after intensive care. Clin Intensive Care 9:199–205Google Scholar
  38. 38.
    Backman CG, Walther SM (2001) Use of a personal diary written on the ICU during critical illness. Intensive Care Med 27:426–429Google Scholar
  39. 39.
    Hames KC, Gager M, Waldmann CS (2001) Patient satisfaction with specialist ICU follow-up. Br J Anaesth 87:372–373Google Scholar
  40. 40.
    Wilkins A, Koshy G, Waldmann CS (1998) Long-term outcomes of patients in ICU with multi-organ failure. Br J Anaesth 81:651Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Department of Anaesthesia and Intensive CareHaukeland University HospitalBergenNorway

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