Changes in quality of life after medical intensive care

Objectives: To determine outcome and changes in health-related quality of life (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 months 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 Physiology and Chronic Health Evaluation II score was 23±10. Cumulative mortality was: ICU 24%, hospital 34%, 6 months 43%. Relative to baseline, follow-up interviews of 185 survivors revealed no significant changes in the overall QOL score (p=0.93). The subscales basic physiological activities (p=0.07) and normal daily activities (p=0.15) showed a nonsignificant deterioration. A significant improvement was noted for the domain emotional state (p=0.013). Conclusions: Six months after admission to a medical ICU most survivors had regained their preadmission health-related QOL. Multivariate analysis showed that preadmission QOL, age, and severity of illness were most strongly associated 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.