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Quality of life in adult survivors of critical illness: A systematic review of the literature

Intensive Care Medicine volume 31, pages 611–620 (2005)Cite this article

An Erratum to this article was published on 11 June 2005

Abstract

Objective: To determine how the quality of life (QOL) of intensive care unit (ICU) survivors compares with the general population, changes over time, and is predicted by baseline characteristics. Design: Systematic literature review including MEDLINE, EMBASE, CINAHL and Cochrane Library. Eligible studies measured QOL ≥30 days after ICU discharge using the Medical Outcomes Study 36-item Short Form (SF-36), EuroQol-5D, Sickness Impact Profile, or Nottingham Health Profile in representative populations of adult ICU survivors. Disease-specific studies were excluded. Measurements and results: Of 8,894 citations identified, 21 independent studies with 7,320 patients were reviewed. Three of three studies found that ICU survivors had significantly lower QOL prior to admission than did a matched general population. During post-discharge follow-up, ICU survivors had significantly lower QOL scores than the general population in each SF-36 domain (except bodily pain) in at least four of seven studies. Over 1–12 months of follow-up, at least two of four studies found clinically meaningful improvement in each SF-36 domain except mental health and general health perceptions. A majority of studies found that age and severity of illness predicted physical functioning. Conclusions: Compared with the general population, ICU survivors report lower QOL prior to ICU admission. After hospital discharge, QOL in ICU survivors improves but remains lower than general population levels. Age and severity of illness are predictors of physical functioning. This systematic review provides a general understanding of QOL following critical illness and can serve as a standard of comparison for QOL studies in specific ICU subpopulations

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Acknowledgements

This research is supported by the National Institutes of Health (ALI SCCOR Grant # P050 HL 73994–01). Dr. Needham is supported by Clinician-Scientist Awards from the Canadian Institutes of Health Research and the University of Toronto, and a Detweiler Fellowship from the Royal College of Physicians and Surgeons of Canada

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Affiliations

  1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    David W. Dowdy

  2. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Artyom Sedrakyan & Peter J. Pronovost

  3. School of Medicine, Johns Hopkins University, Baltimore, MD, USA

    David W. Dowdy & Mark P. Eid

  4. Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA

    Pedro A. Mendez-Tellez & Peter J. Pronovost

  5. Department of Surgery, Johns Hopkins University, Baltimore, MD, USA

    Peter J. Pronovost

  6. Division of Pulmonary & Critical Care Medicine, Johns Hopkins University, 1830 E. Monument Street, 5th floor, Baltimore, MD, 21205, USA

    Dale M. Needham

  7. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada

    Margaret S. Herridge

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  1. David W. Dowdy
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  7. Dale M. Needham
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Correspondence to Dale M. Needham.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00134-005-2704-3

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Dowdy, D.W., Eid, M.P., Sedrakyan, A. et al. Quality of life in adult survivors of critical illness: A systematic review of the literature. Intensive Care Med 31, 611–620 (2005). https://doi.org/10.1007/s00134-005-2592-6

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Keywords

  • Critical care
  • Critical illness
  • Health status indicators
  • Intensive care units
  • Outcome assessment (health care)
  • Quality of life