Monitoring Quality of Life in Critically Ill Patients: a Multicenter Study
Pařízková R., Černý V., Dostál P., Vašátko L. 1 , Hora P. 2 , Herold I. 3 , Novák I. 2 , Nalos D. 1
Klinika anesteziologie, resuscitace a intenzivní medicíny, LF UK a FN, Hradec Králové, přednosta doc. MUDr. Vladimír Černý, PhD., FCCM, 1 Anesteziologicko-resuscitační oddělení, Masarykova nemocnice, Ústí nad Labem, primář MUDr. Daniel Nalos, 2 I. interní klinika – metabolická jednotka intenzivní péče, LF UK a FN, Plzeň, přednosta prof. MUDr. Karel Opatrný, CSc., 3 Anesteziologicko-resuscitační oddělení, Klaudiánova nemocnice, Mladá Boleslav, primář MUDr. Ivan Herold, CSc. |
|
Summary:
The restoration of quality of life has become one of the key goals of the intensive care. Quality of life becomes one of the factors of evaluation the
clinical outcome from the long-term perspective. The aim of the prospective observational study was to assess the quality of life of patients hospitalized
in intensive care units 6 months and one year after the discharge. From the total number of 1,368 patients enrolled to the study, 1,110 were discharged
to home care. Quality of life was assessed according to the questionnaire SF-36 (Short Form 36-Item Health Survey). In all patients the following
parameters were assessed: diagnostic group; APACHE II and SOFA scores; length of hospitalization and clinical outcome. Basic diagnostic groups
were formed by the trauma patients (n = 115), head-brain injury (n = 137), chronic obstructive pulmonary disease (n = 86), post-CPR states (n =
184), ARDS (n = 76) and intoxications (n = 425). Quality of life in the whole set of patients was in all criteria statistically significantly lower compared
to controls in 6 and 12 months after discharge; the most affected dimensions were physical abilities, the ability to perform common daily activities,
and social functions. Statistically significant decrease of selected dimensions could be observed in most diagnostic groups 6 and 12 months after
discharge, except for the group of intoxicated patients in which the restoration of quality of life was comparable to control group 12 months after
discharge. In patients with different SOFA scores no significant changes in selected quality of life dimensions could have been observed 6 or 12 months
after discharge. Higher mortality was associated with advanced age ł 70 years, length of stay ł 14 days and APACHE II score > 20. The quality of
life represents an important part of the clinical outcome. Prediction of the quality of life should become an integral part of complex decision making
process in critically ill patients.
Key words:
intensive care – clinical outcome – quality of life – SF-36
|
