Journal
JOURNAL OF CRITICAL CARE
Volume 48, Issue -, Pages 352-356Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jcrc.2018.09.034
Keywords
Quality of life; Critical illness; Long-term outcomes; Survival; Functional status
Categories
Funding
- [NIH/NHLBIT32 HL098054]
- [NIH/NHLBIT32 HL007891-34]
- [F32 HL139107-01]
- [NIH/NHLBIK99 HL141678]
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [F32HL139107, K01HL141637, K99HL141678, T32HL098054, T32HL007891] Funding Source: NIH RePORTER
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Purpose: To determine how patients perceive their quality of life (QOL) six months following critical illness and to measure dinicians' discriminative accuracy of predicting this outcome. Materials and methods: This prospective cohort study of intensive care unit (ICU) survivors asked patients to report their QOL strictly at six months compared to one month before their critical illness as better, the same, or worse. ICU physicians and nurses made six-month QOL predictions for these patients. Results: Of 162 critical illness survivors, 33% (n - 53) of patients reported six-month QOL as better, 33% (n 54) the same, and 34% (n 55) worse. Abnormal cognition and inability to return to primary pastime or original place of residence (p < .05 for all) were associated with worse self-reported QOL at six months in multivariable regression. Predictions of patient perceptions of QOL at six months were pessimistic and had low discriminative accuracy for both physicians (sensitivity 56%, specificity 53%) and nurses (sensitivity 49%, specificity 57%). Conclusions: Among survivors of critical illness, one-third each reported their six-month post-ICU QOL as better, the same, or worse. Self-reported six-month QOL was associated with six-month function. ICU clinicians should use caution in predicting self-reported QOL, as discriminative accuracy was poor in this cohort. (C) 2018 Elsevier Inc. All rights reserved.
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