Introduction
Materials and methods
Statistics
Results
Patients
Baseline demographics | Enrolled patients | All ICU patients |
---|---|---|
Median age (years) | 60.5 | 64 |
Median APACHE II | 18 | 18 |
Mean ICU length of stay (days) | 6.7 | 5.8 |
Median ICU length of stay (days) | 2.0 | 2.0 |
Female (%) | 41% | 41% |
ICU mortality (%) | 0% | 23.8% |
Surgical admission (%) | 48% | 51% |
Medical admission (%) | 39% | 39% |
Other admission (%) | 13% | 10% |
Hospital mortality (%) | 3.7% | 31.1% |
Quality of life
Total patient number | Physical functioning | Role physical | Bodily pain | General health | Vitality | Social functioning | Role emotional | Mental health | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pre-morbid
| 300 | 57.9 | (36.7) | 53.5 | (37.6) | 55.9 | (34.9) | 54.0 | (27.5) | 43.4 | (27.8) | 57.8 | (34.7) | 64.4 | (35.0) | 62.6 | (25.4) |
3 months
| 202 | 56.3 | (31.9) | 45.9 | (33.7) | 62.1 | (31.0) | 55.4 | (24.9) | 46.9 | (22.7) | 60.8 | (36.3) | 74.9 | (32.3) | 72.9 | (21.3) |
6 months
| 181 | 59.8 | (30.4) | 53.2 | (34.6) | 65.1 | (31.9) | 57.3 | (25.9) | 51.8 | (24.0) | 67.9 | (33.5) | 79.1 | (30.3) | 75.2 | (21.2) |
1 year
| 148 | 61.4 | (31.4) | 56.9 | (35.2) | 70.6 | (30.4) | 59.4 | (25.3) | 51.6 | (24.5) | 70.8 | (32.7) | 80.1 | (28.8) | 75.9 | (20.5) |
2.5 years
| 127 | 58.8 | (32.6) | 62.0 | (34.2) | 70.7 | (30.7) | 57.9 | (27.0) | 53.4 | (25.7) | 76.0 | (29.4) | 84.4 | (25.9) | 75.9 | (19.0) |
5 years
| 97 | 52.5 | (34.0) | 58.0 | (34.6) | 59.8 | (33.4) | 55.7 | (29.3) | 50.1 | (25.4) | 73.1 | (32.0) | 79.1 | (30.0) | 75.5 | (20.0) |
UK normals
| 76.2 | (22.3) | 75.9 | (37.5) | 76.9 | (24.0) | 68.1 | (21.9) | 61.8 | (21.2) | 86.2 | (22.7) | 84.8 | (30.6) | 76.4 | (18.4) |
Physical component score | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Parameter | Range | N (%) | Pre-morbid | 3 months | 6 months | 1 year | 2.5 years | 5 years | ||||||
Age
|
≤ 64 years
| 184 (61) | 37.1 | (17.0) | 32.4 | (13.9) | 34.2 | (14.6) | 36.3 | (15.6) | 36.3 | (16.1) | 34.5 | (16.8) |
> 64 years
| 116 (39) | 32.3 | (14.1) | 33.1 | (12.6) | 35.2 | (13.8) | 36.9 | (12.9) | 36.1 | (13.9) | 28.4 | (15.5) | |
P
value
| 0.01 | 0.69 | 0.66 | 0.80 | 0.94 | 0.09 | ||||||||
APACHE II
|
≤ 18
| 158 (53) | 37.6 | (16.3) | 33.3 | (13.4) | 34.6 | (15.0) | 36.8 | (15.0) | 37.2 | (15.1) | 33.7 | (17.6) |
> 18
| 142 (47) | 32.6 | (15.5) | 31.8 | (13.5) | 34.5 | (13.4) | 36.0 | (14.3) | 34.7 | (15.7) | 31.1 | (15.1) | |
P
value
| 0.01 | 0.42 | 0.96 | 0.74 | 0.37 | 0.44 | ||||||||
LOS
|
≤ 2 days
| 162 (54) | 36.0 | (15.6) | 35.5 | (12.8) | 35.2 | (14.7) | 37.3 | (14.4) | 36.4 | (15.8) | 32.9 | (16.2) |
> 2 days
| 136 (46) | 34.4 | (16.7) | 28.7 | (13.4) | 33.7 | (13.8) | 35.3 | (15.1) | 36.0 | (14.8) | 32.1 | (17.2) | |
P
value
| 0.38 | < 0.001 | 0.46 | 0.42 | 0.91 | 0.82 | ||||||||
Type of
admission
|
Surgical
| 106 (35) | 33.2 | (14.5) | 34.4 | (11.3) | 35.2 | (13.8) | 34.9 | (14.4) | 33.6 | (15.4) | 27.9 | (15.8) |
Medical
| 118 (39) | 32.6 | (16.7) | 30.2 | (14.1) | 32.3 | (14.4) | 35.1 | (14.9) | 35.8 | (14.7) | 29.5 | (16.3) | |
P
value
| 0.77 | 0.05 | 0.23 | 0.94 | 0.51 | 0.69 | ||||||||
Long-term
survival
|
Survivor
| 197 (66) | 36.9 | (15.7) | 33.6 | (13.0) | 34.8 | (13.8) | 37.1 | (15.3) | 35.9 | (15.4) | 32.6 | (16.6) |
Non-survivor
| 103 (34) | 34.4 | (16.3) | 31.6 | (13.9) | 34.3 | (15.1) | 35.0 | (13.2) | 37.6 | (15.2) | . | . | |
p-value
| 0.189 | 0.298 | 0.805 | 0.384 | 0.622 |
Mental component score | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Parameter | Range | % | Pre-morbid | 3 months | 6 months | 1 year | 2.5 years | 5 years | ||||||
Age
|
≤ 64 years
| 184 (61) | 44.2 | (14.4) | 49.2 | (11.5) | 50.2 | (11.8) | 50.7 | (12.0) | 53.7 | (9.6) | 52.7 | (11.6) |
> 64 years
| 116 (39) | 47.2 | (12.6) | 53.2 | (10.7) | 56.7 | (8.6) | 56.0 | (8.4) | 55.1 | (8.6) | 56.5 | (11.6) | |
P
value
| 0.06 | 0.02 | < 0.001 | 0.002 | 0.40 | 0.13 | ||||||||
APACHE II
|
≤ 18
| 158 (53) | 46.5 | (14.3) | 50.9 | (11.6) | 52.1 | (11.1) | 51.7 | (11.7) | 53.8 | (9.2) | 53.5 | (11.1) |
> 18
| 142 (47) | 44.1 | (13.1) | 50.3 | (11.2) | 53.1 | (11.3) | 53.7 | (10.4) | 54.5 | (9.4) | 54.4 | (12.6) | |
P
value
| 0.12 | 0.74 | 0.55 | 0.27 | 0.68 | 0.71 | ||||||||
LOS
|
≤ 2 days
| 162 (54) | 45.9 | (13.7) | 51.2 | (11.9) | 53.1 | (11.3) | 51.2 | (12.0) | 53.8 | (9.1) | 54.9 | (10.6) |
> 2 days
| 136 (46) | 44.7 | (13.9) | 50.0 | (10.6) | 51.8 | (11.1) | 54.2 | (9.8) | 54.5 | (9.5) | 52.6 | (13.0) | |
P
value
| 0.43 | 0.44 | 0.46 | 0.10 | 0.70 | 0.36 | ||||||||
Type of
Admission
|
Surgical
| 106 (35) | 46.7 | (12.5) | 52.2 | (11.2) | 53.6 | (10.5) | 52.1 | (10.7) | 54.3 | (7.2) | 54.9 | (10.6) |
Medical
| 118 (39) | 43.1 | (13.8) | 49.5 | (12.3) | 51.6 | (12.8) | 54.1 | (11.4) | 54.1 | (10.5) | 53.8 | (14.0) | |
P
value
| 0.04 | 0.17 | 0.32 | 0.35 | 0.94 | 0.70 | ||||||||
Long-term survival
|
Survivor
| 197 (66) | 47.9 | (12.7) | 53.1 | (9.4) | 53.5 | (9.6) | 53.2 | (10.1) | 54.9 | (8.5) | 53.9 | (11.7) |
Non-survivor
| 103 (34) | 44.0 | (14.2) | 48.1 | (12.6) | 51.2 | (12.9) | 51.1 | (13.2) | 50.8 | (11.8) | . | . | |
P
value
| 0.016 | 0.002 | 0.196 | 0.338 | 0.117 |
Satisfaction with QOL
EQ-5D scores
Cummulative QALYS
Discussion
Survival
Changes in quality of life over five years
Factors affecting quality of life
Satisfaction with quality of life
Comparisons with the general population
Strengths and limitations of the study
Conclusions
Key messages
-
Quality of life is poor compared with age- and sex-matched controls before ICU admission.
-
Patients discharge from ICU alive have a high ongoing mortality in the five years after discharge.
-
Quality of life is extremely poor compared with age- and sex-matched controls after ICU discharge for the first year.
-
After recovering to levels consistent with age- and sex-matched controls, quality of life markedly deteriorates between 2.5 and 5 years after ICU discharge.
-
In the five years after ICU admission patients accumulate QALYS at an extremely low rate compared with age- and sex-matched controls.