Changes in quality of life after medical intensive care

Objectives: To determine outcome and changes in health-related quality of l ife (QOL) in medical intensive care patients. Design and setting: Prospective comparison of QOL before and 6 months after intensive care unit (ICU) admission in a 12-bed noncoronary medical ICU of a university hospital. Patients: All 325 consecutively admitted adult patients who spent at least 24 h on the ICU were eligible. Measurements and results: QOL measurements were collected before and 6 mont hs after ICU admission. Comorbidity classified by the Charlson index was 2. 44 +/- 1.96. Mean stay in the ICU was 10.4 +/- 15.1 days, mean Acute Physio logy and Chronic Health Evaluation II scare was 23 +/- 10. Cumulative morta lity was: ICU 24%, hospital 34%, 6 months 43%. Relative to baseline, follow -up interviews of 185 survivors revealed no significant changes in the over all QOL score (p = 0.93). The subscales basic physiological activities (p = 0.07) and normal daily activities (p = 0.15) showed a nonsignificant deter ioration. A significant improvement was noted for the domain emotional stat e (p = 0.013). Conclusions: Six months after admission to a medical ICU most survivors had regained their preadmission health-related QOL. Multivariate analysis show ed that preadmission QOL, age, and severity of illness were most strongly a ssociated with follow-up QOL. Of the survivors 86% were living at home, and all but one of those previously in employment had returned to their former work. Most patients (94%) would undergo ICU treatment again if necessary.