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

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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.

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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 25–P 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

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Conflicts of interest

The authors declare that they have no competing interest.

Author information

Authors and Affiliations

  1. Department of Intensive Care, Gelre Ziekenhuizen Hospital, Albert Schweitzerlaan 31, 7334 DZ, Apeldoorn, The Netherlands

    José G. M. Hofhuis, Johannes H. Rommes & Peter E. Spronk

  2. Julius Center for Health Sciences and Primary Care, University Medical Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Henk F. van Stel & Augustinus J. P. Schrijvers

  3. Department of Intensive Care, Academic Medical Center, Gelre Hospital, Apeldoorn, Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Peter E. Spronk

Authors
  1. José G. M. Hofhuis
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  2. Henk F. van Stel
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  3. Augustinus J. P. Schrijvers
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  4. Johannes H. Rommes
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  5. Peter E. Spronk
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Corresponding author

Correspondence to José G. M. Hofhuis.

Additional information

Take home message: 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.

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Hofhuis, J.G.M., van Stel, H.F., Schrijvers, A.J.P. et al. ICU survivors show no decline in health-related quality of life after 5 years. Intensive Care Med 41, 495–504 (2015). https://doi.org/10.1007/s00134-015-3669-5

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  • DOI: https://doi.org/10.1007/s00134-015-3669-5

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