Quality of life after stay in surgical intensive care unit

被引：15
作者：
Abelha F.J. [1 ]
Santos C.C. [2 ]
Maia P.C. [1 ]
Castro M.A. [1 ]
Barros H. [3 ]
机构：
[1] Department of Anesthesia and Intensive Care, Hospital de São João, Porto
[2] Biostatistics and Medical Informatics Department, University of Porto Medical School, Porto
[3] Department of Hygiene and Epidemiology, University of Porto Medical School, Porto
来源：
BMC Anesthesiology | / 7卷 / 1期
关键词：
Intensive Care Unit; Intensive Care Unit Admission; Intensive Care Unit Stay; Intensive Care Unit Discharge; ADLI Task;
D O I：
10.1186/1471-2253-7-8
中图分类号：
学科分类号：
摘要：
Background: In addition to mortality, Health Related Quality of Life (HRQOL) has increasingly been claimed as an important outcome variable. The aim of this study was to assess HRQOL and independence in activities of daily living (ADL) six months after discharge from an Intensive Care Unit (ICU), and to study its determinants. Methods: All post-operative adult patients admitted to a surgical ICU between October 2004 and July 2005, were eligible for the study. The following variables were recorded on admission: age, gender, American Society of Anesthesiologists physical status (ASA-PS), type and magnitude of surgical procedure, ICU and hospital length of stay (LOS), mortality and Simplified Acute Physiology Score II (SAPS II). Six months after discharge, a Short Form-36 questionnaire (SF-36) and a questionnaire to assess dependency in ADL were sent to all survivors. Descriptive statistics was used to summarize data. Patient groups were compared using non-parametric tests. A logistic regression analysis was performed to identify covariate effects of each variable on dependency in personal and instrumental ADL, and for the change-in-health question of SF-36. Results: Out of 333 hospital survivors, 226 completed the questionnaires. Fifty-nine percent reported that their general level of health was better on the day they answered the questionnaire than 12 months earlier. Patients with greater co-morbidities (ASA-PS III/IV), had lower SF-36 scores in all domains and were more frequently dependent in instrumental and personal ADL. Logistic regression showed that SAPS II was associated with changes in general level of health (OR 1.06, 95%CI, 1.01 - 1.11, p = 0,016). Six months after ICU discharge, 60% and 34% of patients, respectively, were dependent in at least one activity in instrumental ADL (ADLI) and personal ADL (ADLP). ASA-PS (OR 3.00, 95%CI 1.31 - 6.87, p = 0.009) and age (OR 2.36, 95%CI, 1.04 5.34, p = 0.04) were associated with dependency in ADLI. For ADLP, only ASA-PS (OR 4.58, 95%CI, 1.68-12.46, p = 0.003) was associated with higher dependency. Conclusion: ASA-PS, age, type of surgery, ICU LOS and SAPS II could be seen as determinants of HRQOL. © 2007 Abelha et al; licensee BioMed Central Ltd.
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