Health-related quality of life of multiple organ dysfunction patients one year after intensive care

Abstract

Objective: To assess the quality of life (QOL) of intensive care survivors 1 year after discharge with special emphasis on multiple organ dysfunction (MOD). Design: Prospective, observational study. Setting: A ten-bed medical-surgical intensive care unit in a tertiary care hospital. Patients: Among the 591 consecutive patients admitted in the year 1995, 307 of 378 patients who survived 1 year were studied. Interventions: None. Measurements and results: A generic scale assessing health-related QOL, the RAND 36-item Health Survey (RAND 36) was sent by mail 12 months after discharge. Data concerning age, severity of illness, organ dysfunctions and diagnoses were recorded. Of 307 patients, 98 (31.9%) were able to work. The QOL measured by the RAND 36 showed clinically relevant impairment in emotional and physical role limitations compared with an age- and sex-matched general population. MOD (n=131, 42.7%) had a statistically significant negative effect on all QOL domains, except bodily pain and mental health, with the only clinically relevant impairment being in vitality and emotional role limitations compared with non-MOD patients. Of the 131 MOD patients, 36 (27.4%) were able to work, 26 (19.8%) had severe limitations in their daily activities and 5 (3.8%) were unable to live at home 1 year after discharge. Conclusions: One year after intensive care the survivors had a lower QOL than an age-matched general population with clinically relevant further impairment of MOD patients in vitality and emotional role limitations.