Quality of life six years after intensive care

Objective: To assess the degree of change in long-term quality of life (QOL) in critically ill patients 1 and 6 years after discharge from the intensive care unit (ICU). Design: Prospective observational study. Setting: A ten-bed medical-surgical ICU in a tertiary care hospital. Patients: Of the 591 consecutive patients admitted in 1995 the study comprised those 169 who responded to both QOL questionnaires, sent in 1996 and 2001. Interventions: None. Measurements and main results: A generic scale assessing health-related QOL, the RAND 36, sent by mail. Six years after discharge 9% of the patients considered their present health status as excellent, 37% as good, 45% as satisfactory and 9% as poor. The absolute values of the different QOL domains revealed worse physical functioning (p<0.001), pain (p=0.008) and general health (p=0.012), but less emotional role limitation (p=0.006) as compared with the 1996 values. Compared with the age- and gender-matched general population (controls), a marked improvement was detected in physical and emotional role limitations, and in vitality. However, 6 years after ICU discharge pain was worse, and physical functioning and general health were still reduced as compared with controls. Conclusions: When evaluating the long-term outcome of ICU patients, the timing of QOL assessment is essential; especially the emotional domains seem to improve slowly. Further studies focusing on the effect of time on various QOL domains and the predictive factors for a long-term QOL are therefore warranted.