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Intensive Care Medicine

, Volume 41, Issue 3, pp 495–504 | Cite as

ICU survivors show no decline in health-related quality of life after 5 years

  • José G. M. Hofhuis
  • Henk F. van Stel
  • Augustinus J. P. Schrijvers
  • Johannes H. Rommes
  • Peter E. Spronk
Original

Abstract

Purpose

Severe critical illness requiring treatment in the intensive care unit (ICU) may have a serious impact on patients and their families. However, optimal follow-up periods are not defined and data on health-related quality of life (HRQOL) before ICU admission as well as those beyond 2 years follow-up are limited. The aim of our study was to assess the impact of ICU stay up to 5 years after ICU discharge.

Methods

We performed a long-term prospective cohort study in patients admitted for longer than 48 h in a medical-surgical ICU. The Short-Form 36 was used to evaluate HRQOL before admission (by proxy within 48 h after admission of the patient), at ICU discharge, and at 1, 2, and 5 years following ICU discharge (all by patients). Changes in HRQOL were assessed using linear mixed modeling.

Results

We included a total of 749 patients (from 2000 to 2007). At 5 years after ICU discharge 234 patients could be evaluated. After correction for natural decline in HRQOL, the mean scores of four dimensions—physical functioning (p < 0.001), role-physical (p < 0.001), general health (p < 0.001), and social functioning (p = 0.003)—were still significantly lower 5 years after ICU discharge compared with their pre-admission levels, although effect sizes were small (<0.5).

Conclusions

After correction for natural decline, the effect sizes of decreases in HRQOL were small, suggesting that patients regain their age-specific HRQOL 5 years after their ICU stay.

Keywords

Critical care Long-term outcome SF-36 HRQOL Natural decline 

Abbreviations

APACHE II

Acute physiology and chronic health evaluation

BP

Bodily pain

CAM-ICU

Confusion assessment method for the ICU

EQ-5D

EuroQol-5-D

GH

General health

HRQOL

Health-related quality of life

ICU

Intensive care unit

IQR

Interquartile range (P 25P 75)

LOS

Length of stay

MCS

Mental component score

MH

Mental health

PCS

Physical component score

PF

Physical functioning

RE

Role limitation due to emotional problems

RP

Role limitation due to physical problems

SF

Social functioning

SF-36

Medical Outcomes Study 36-item short form

VT

Vitality

Notes

Conflicts of interest

The authors declare that they have no competing interest.

Supplementary material

134_2015_3669_MOESM1_ESM.doc (86 kb)
Flow diagram of the patients screened and included in the study (DOC 87 kb)
134_2015_3669_MOESM2_ESM.doc (47 kb)
Demographic and clinical characteristics of analyzed group and lost to follow-up (DOC 47 kb)
134_2015_3669_MOESM3_ESM.doc (34 kb)
Estimates of change over time from ICU discharge* corrected for natural decline (DOC 35 kb)
134_2015_3669_MOESM4_ESM.doc (36 kb)
Pre-admission HRQOL of non-survivors compared with survivors (DOC 37 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  • José G. M. Hofhuis
    • 1
  • Henk F. van Stel
    • 2
  • Augustinus J. P. Schrijvers
    • 2
  • Johannes H. Rommes
    • 1
  • Peter E. Spronk
    • 1
    • 3
  1. 1.Department of Intensive CareGelre Ziekenhuizen HospitalApeldoornThe Netherlands
  2. 2.Julius Center for Health Sciences and Primary CareUniversity Medical CenterUtrechtThe Netherlands
  3. 3.Department of Intensive Care, Academic Medical CenterGelre Hospital, ApeldoornAmsterdamThe Netherlands

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