Quality of life 6 months after intensive care: results of a prospective multicenter study using a generic health status scale and a satisfaction scale

Abstract

Objective: To assess the quality of life of intensive care survivors 6 months after discharge. Design: Multicenter prospective study. Setting: Medical-surgical intensive care units (ICUs) of four French university hospitals. Patients: Among the 589 patients admitted to the four ICUs between 1 January and 31 March 1989, 329 were investigated. Measurements and results: A generic scale assessing health-related quality of life, the Nottingham Health Profile (NHP), a satisfaction scale, the Perceived Quality of Life scale (PQOL) and a questionnaire on professional status were sent by mail 6 months after discharge. Data concerning age, severity of acute illness (assessed by the Simplified Acute Physiology Score) and main diagnosis were recorded. A total of 223 questionnaires (67.8 %) were analysable. The professional status remained unchanged in 79.7 % of the patients, despite a significant (p < 0.01) increase (15.3 vs 22.1 %) in sick leave. Quality of life, assessed with NHP, was fair (50^th percentile = 0.73 on a 0 to 1 scale), whereas satisfaction measured by PQOL was lower (50^th percentile = 0.61). Both scales correlated well (z = 9.853; p = 0.0001) but with a large dispersion. The NHP scale showed a severe reduction in energy, sleep and emotional reactions, whereas social isolation, pain and physical handicap were infrequent. Family support was rated with the PQOL score as very good, whereas dissatisfaction concerning recreational and professional activities was expressed. Subsequent sick leave was associated with a poor quality of life (p < 0.05). Quality of life was mainly a function of the diagnosis, not of age and severity of illness: patients admitted for suicide attempt or chronic obstructive pulmonary disease fared poorly. Conclusions: Quality of life measured with a health-related quality of life scale and a satisfaction scale 6 months after an ICU stay depended on the admission diagnosis. Different dimensions of quality of life were variably affected.