Quality of life one year after discharge from the ICU
Authors:
Židková Alexandra; Chytra Ivan; Šestáková Blanka; Kasal Eduard; Týblová Iveta
Authors‘ workplace:
Anesteziologicko-resuscitační klinika, Fakultní nemocnice v Plzni, Univerzita Karlova v Praze, Lékařská fakulta v Plzni
Published in:
Anest. intenziv. Med., 23, 2012, č. 2, s. 75-81
Category:
Intensive Care Medicine - Original Paper
Overview
Objective:
Assessment of the quality of life one year after ICU discharge.
Design:
Prospective observational study.
Setting:
Dept. of Anesthesiology and Intensive Care Medicine of University Hospital.
Materials and methods:
Quality of life before admission and one year after discharge from the ICU was assessed by EuroQoL-5D and State Trait Anxiety Inventory questionnaires. The Wilcoxon signed-rank test, χ2 and Fisher’s exact test were used for statistical analysis with p < 0.05 considered statistically significant. Stepwise logistic regression analysis was performed to evaluate the dependence of the single dimensions of quality of life on age, severity of the condition on admission to the ICU, length of ICU stay, length of mechanical ventilation, level of organ dysfunction and previous quality of life.
Results:
The questionnaires were sent to 483 patients of whom 194 (41.2%) responded. At one year from discharge all the dimensions of the EuroQoL-5D deteriorated. Mobility deteriorated by 20.1%, self-care deteriorated by 28.9%, daily activities deteriorated by 39.2%, pain by 44.8% and the feelings of anxiety by 29.9%. Increased anxiety in men (37.4%) and in women (21.1%) was confirmed by using the State Trait Anxiety Inventory questionnaire. All the mentioned changes were significant (p < 0.0001). Independent predictors of worsening of the quality of life were age, length of ICU stay, length of mechanical ventilation and presence of pain and anxiety before ICU admission.
Conclusion:
The stay on the ICU was associated with deterioration of the quality of life in all the evaluated aspects at one year after discharge. Quality of life after the discharge from the ICU was influenced by age, length of ICU stay, length of mechanical ventilation and previous quality of life.
Keywords:
quality of life – intensive care – EuroQoL-5D – State Trait Anxiety Inventory (STAI) – Posttraumatic Stress Disorder (PTSD)
Sources
1. Bowling A., Bowling, A. Measuring disease. Open Univ Pr; 2001.
2. Scragg, P., Jones, A., Fauvel, N. Psychological problems following ICU treatment. Anaesthesia, 2001, 56, 1, p. 9–14.
3. The EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy, 1990, 16, (3) p. 199–208.
4. Mindgarden Inc. (2008). State-Trait Anxiety Inventory for Adults. Retrieved 2/25/08 from
http://www. mindgarden.com/products/staisad.htm.
5. Badia, X., Diaz-Prieto, A., Gorriz, M. T., Herdman, M., Torrado, H., Farrero, E., Cavanilles, J. M. Using the EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit. Intensive Care Med., 2001, 27, 12, p. 1901–1907.
6. García Lizana, F., Manzano Alonso, J. L., González Santana, B., Fuentes Esteban, J., Saavedra Santana, P. Survival and quality of life of patients with multiple organ failure one year after leaving an intensive care unit. Med. Clin. Barc., 2000, 114 Suppl 3, p. 99–103.
7. Granja, C., Teixeira-Pinto, A., Costa-Pereira, A. Quality of life after intensive care – evaluation with EQ-5D questionnaire. Intensive Care Med., 2002, 28, 7, p. 898–907.
8. Vincent, J. L., de Mendonça, A., Cantraine, F., Moreno, R., Takala, J., Suter, P. M., Sprung, C. L., Colardyn, F., Blecher, S. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine. Crit Care Med., 1998, 26, 11, p. 1793–1800.
9. Pařízková, R., Černý, V., Dostál, P., Vašátko, L., Hora, P., Herold, I., Novák, I., Nalos, D. Sledování kvality života u nemocných v intenzivní péči – multicentrická studie. Anest. intenziv. Med., 2001, 5, p. 240–251.
10. Ridley, S. A., Chrispin, P. S., Scotton, H., Rogers, J., Lloyd, D. Changes in quality of life after intensive care: comparison with normal data. Anaesthesia, 1997, 52, 3, p. 195–202.
11. Chocron, S., Etievent, J. P., Viel, J. F., Dussaucy, A., Clement, F., Alwan, K., Neidhardt, M., Schipman, N. Prospective study of quality of life before and after open heart operations. Ann. Thorac. Surg., 1996, 61, 1, p. 153–157.
12. Bryan, S., Ratcliffe, J., Neuberger, J. M., Burroughs, A. K., Gunson, B. K., Buxton, M. J. Health-related quality of life following liver transplantation. Qual. Life Res., 1998, 7, (2) p. 115–120.
13. Griffiths, J., Fortune, G., Barber, V., Young, J. D. The prevalence of post traumatic stress disorder in survivors of ICU treatment: a systematic review. Intensive Care Med., 2007, 33, 9, p. 1506–1518.
14. O’Donnell, M. L., Creamer, M., Pattison, P., Atkin, C. Psychiatric morbidity following injury. Am. J. Psychiatry, 2004, 161, 3, p. 507–514.
15. Schelling, G., Stoll, C., Haller, M., Briegel, J., Manert, W., Hummel, T., Lenhart, A., Heyduck, M., Polasek, J., Meier, M., Preuss, U., Bullinger, M., Schüffel, W., Peter, K. Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome. Crit. Care Med., 1998, 26, 4, p. 651–659.
16. Kress, J. P., Gehlbach, B., Lacy, M., Pliskin, N., Pohlman, A. S., Hall, J. B. The long-term psychological effects of daily sedative interruption on critically ill patients. Am. J. Respir. Crit. Care Med., 2003, 168, 12, p. 1457–1461.
17. Hofhuis, J. G. M., Spronk, P. E., van Stel, H. F., Schrijvers, A. J. P., Rommes, J. H., Bakker, J. Experiences of critically ill patients in the ICU. Intensive Crit. Care Nurs., 2008, 24, 5, p. 300–313.
18. Mellman, T. A., Hipolito, M. M. S. Sleep disturbances in the aftermath of trauma and posttraumatic stress disorder. CNS Spectr., 2006, 11, (8) p. 611–615.
19. Salluh, J. I., Soares, M., Teles, J. M., Ceraso, D., Raimondi, N., Nava, V. S., Blasquez, P., Ugarte, S., Ibanez-Guzman, C., Centeno, J. V., Laca, M., Grecco, G., Jimenez, E., Árias-Rivera, S., Duenas, C., Rocha, M. G. Delirium Epidemiology in Critical Care Study Group Delirium epidemiology in critical care (DECCA): an international study. Crit. Care, 2010, 14, 6, p. R210.
20. Davydow, D. S. Symptoms of depression and anxiety after delirium. Psychosomatics, 2009, 50, 4, p. 309–316.
21. Jones, C., Griffiths, R. D., Humphris, G., Skirrow, P. M. Memory, delusions, and the development of acute posttraumatic stress disorder-related symptoms after intensive care. Crit. Care Med., 2001, 29, 3, p. 573–580.
22. Weinert, C. Epidemiology and treatment of psychiatric conditions that develop after critical illness. Curr. Opin. Crit. Care, 2005, 11, 4, p. 376–380.
23. Dowdy, D. W., Dinglas, V., Mendez-Tellez, P. A., Bienvenu, O. J., Sevransky, J., Dennison, C. R., Shanholtz, C., Needham, D. M. Intensive care unit hypoglycemia predicts depression during early recovery from acute lung injury. Crit. Care Med., 2008, 36, 10, p. 2726–2733.
24. Hauer, D., Weis, F., Krauseneck, T., Vogeser, M., Schelling, G., Roozendaal, B. Traumatic memories, post-traumatic stress disorder and serum cortisol levels in long-term survivors of the acute respiratory distress syndrome. Brain Res., 2009, 1293, p. 114–120.
25. Weis, F., Kilger, E., Roozendaal, B., de Quervain, D. J. F., Lamm, P., Schmidt, M., Schmölz, M., Briegel, J., Schelling, G. Stress doses of hydrocortisone reduce chronic stress symptoms and improve health-related quality of life in high-risk patients after cardiac surgery: a randomized study. J. Thorac. Cardiovasc. Surg., 2006, 131, 2, p. 277–282.
26. Jackson, J. C., Hart, R. P., Gordon, S. M., Shintani, A., Truman, B., May, L., Ely, E. W. Six-month neuropsychological outcome of medical intensive care unit patients. Crit. Care Med., 2003, 31, 4, p. 1226–1234.
27. Hatch, R., McKechnie, S., Griffiths, J. Psychological intervention to prevent ICU-related PTSD: who, when and for how long? Crit. Care, 2011, 15, 2, p. 141.
28. Rattray, J. E., Johnston, M., Wildsmith, J. A. W. Predictors of emotional outcomes of intensive care. Anaesthesia, 2005, 60, 11, p. 1085–1092.
29. Weinert, C., Meller, W. Epidemiology of depression and antidepressant therapy after acute respiratory failure. Psychosomatics, 2006, 47, (5) p. 399–407.
30. Eddleston, J. M., White, P., Guthrie, E. Survival, morbidity, and quality of life after discharge from intensive care. Crit. Care Med., 2000, 28, 7, p. 2293–2299.
31. García Lizana, F., Peres Bota, D., De Cubber, M., Vincent, J. L. Long-term outcome in ICU patients: what about quality of life? Intensive Care Med., 2003, 29, 8, p. 1286–1293.
32. Zatzick, D., Jurkovich, G. J., Rivara, F. P., Wang, J., Fan, M. Y., Joesch, J., Mackenzie, E. A national US study of posttraumatic stress disorder, depression, and work and functional outcomes after hospitalization for traumatic injury. Ann. Surg., 2008, 248, 3, p. 429–437.
33. Peris, A., Bonizzoli, M., Iozzelli, D., Migliaccio, M. L., Zagli, G., Bacchereti, A., Debolini, M., Vannini, E., Solaro, M., Balzi, I., Bendoni, E., Bacchi, I., Trevisan, M., Giovannini, V., Belloni, L. Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients. Crit. Care, 2011, 15, 1, p. R41.
34. Jones, C., Skirrow, P., Griffiths, R. D., Humphris, G. H., Ingleby, S., Eddleston, J., Waldmann, C., Gager, M. Rehabilitation after critical illness: a randomized, controlled trial. Crit. Care Med., 2003, 31, p. 2456–2461.
35. Cuthbertson, B. H., Rattray, J., Campbell, M. K., Gager, M., Roughton, S., Smith, A., Hull, A., Breeman, S., Norrie, J., Jenkinson, D., Hernández, R., Johnston, M., Wilson, E., Waldmann, C., PRaCTICaL study group The PRaCTICaL study of nurse led, intensive care follow-up programmes for improving long term outcomes from critical illness: a pragmatic randomised controlled trial. BMJ, 2009, 339, p. b3723.
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