Limits...
Quality of life in the five years after intensive care: a cohort study.

Cuthbertson BH, Roughton S, Jenkinson D, Maclennan G, Vale L - Crit Care (2010)

Bottom Line: During the five years after intensive care unit, the cumulative quality adjusted life years were significantly lower than that expected for the general population (P < 0.001).Intensive care unit admission is associated with a high mortality, a poor physical quality of life and a low quality adjusted life years gained compared to the general population for 5 years after discharge.In this group, critical illness associated with ICU admission should be treated as a life time diagnosis with associated excess mortality, morbidity and the requirement for ongoing health care support.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, M4N 3M5, Canada. brian.cuthbertson@sunnybrook.ca

ABSTRACT

Introduction: Data on quality of life beyond 2 years after intensive care discharge are limited and we aimed to explore this area further. Our objective was to quantify quality of life and health utilities in the 5 years after intensive care discharge.

Methods: A prospective longitudinal cohort study in a University Hospital in the UK. Quality of life was assessed from the period before ICU admission until 5 years and quality adjusted life years calculated.

Results: 300 level 3 intensive care patients of median age 60.5 years and median length of stay 6.7 days, were recruited. Physical quality of life fell to 3 months (P = 0.003), rose back to pre-morbid levels at 12 months then fell again from 2.5 to 5 years after intensive care (P = 0.002). Mean physical scores were below the population norm at all time points but the mean mental scores after 6 months were similar to those population norms. The utility value measured using the EuroQOL-5D quality of life assessment tool (EQ-5D) at 5 years was 0.677. During the five years after intensive care unit, the cumulative quality adjusted life years were significantly lower than that expected for the general population (P < 0.001).

Conclusions: Intensive care unit admission is associated with a high mortality, a poor physical quality of life and a low quality adjusted life years gained compared to the general population for 5 years after discharge. In this group, critical illness associated with ICU admission should be treated as a life time diagnosis with associated excess mortality, morbidity and the requirement for ongoing health care support.

Show MeSH
Cumulative mean quality adjusted life year (QALYs) in ICU survivors up to five years after ICU discharge (solid line) compared to normal population (dotted line). After five years the ICU cohort has accumulated significantly less QALYs (P < 0.001) than the age- and sex-matched cohort of the general population. ICU = intensive care unit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2875518&req=5

Figure 5: Cumulative mean quality adjusted life year (QALYs) in ICU survivors up to five years after ICU discharge (solid line) compared to normal population (dotted line). After five years the ICU cohort has accumulated significantly less QALYs (P < 0.001) than the age- and sex-matched cohort of the general population. ICU = intensive care unit.

Mentions: Figure 5 shows the cumulative QALYs in ICU survivors up to five years after ICU discharge compared with the general population. After five years the ICU cohort has accumulated significantly less QALYs (P < 0.001) than the age- and sex-matched cohort of the general population.


Quality of life in the five years after intensive care: a cohort study.

Cuthbertson BH, Roughton S, Jenkinson D, Maclennan G, Vale L - Crit Care (2010)

Cumulative mean quality adjusted life year (QALYs) in ICU survivors up to five years after ICU discharge (solid line) compared to normal population (dotted line). After five years the ICU cohort has accumulated significantly less QALYs (P < 0.001) than the age- and sex-matched cohort of the general population. ICU = intensive care unit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2875518&req=5

Figure 5: Cumulative mean quality adjusted life year (QALYs) in ICU survivors up to five years after ICU discharge (solid line) compared to normal population (dotted line). After five years the ICU cohort has accumulated significantly less QALYs (P < 0.001) than the age- and sex-matched cohort of the general population. ICU = intensive care unit.
Mentions: Figure 5 shows the cumulative QALYs in ICU survivors up to five years after ICU discharge compared with the general population. After five years the ICU cohort has accumulated significantly less QALYs (P < 0.001) than the age- and sex-matched cohort of the general population.

Bottom Line: During the five years after intensive care unit, the cumulative quality adjusted life years were significantly lower than that expected for the general population (P < 0.001).Intensive care unit admission is associated with a high mortality, a poor physical quality of life and a low quality adjusted life years gained compared to the general population for 5 years after discharge.In this group, critical illness associated with ICU admission should be treated as a life time diagnosis with associated excess mortality, morbidity and the requirement for ongoing health care support.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, M4N 3M5, Canada. brian.cuthbertson@sunnybrook.ca

ABSTRACT

Introduction: Data on quality of life beyond 2 years after intensive care discharge are limited and we aimed to explore this area further. Our objective was to quantify quality of life and health utilities in the 5 years after intensive care discharge.

Methods: A prospective longitudinal cohort study in a University Hospital in the UK. Quality of life was assessed from the period before ICU admission until 5 years and quality adjusted life years calculated.

Results: 300 level 3 intensive care patients of median age 60.5 years and median length of stay 6.7 days, were recruited. Physical quality of life fell to 3 months (P = 0.003), rose back to pre-morbid levels at 12 months then fell again from 2.5 to 5 years after intensive care (P = 0.002). Mean physical scores were below the population norm at all time points but the mean mental scores after 6 months were similar to those population norms. The utility value measured using the EuroQOL-5D quality of life assessment tool (EQ-5D) at 5 years was 0.677. During the five years after intensive care unit, the cumulative quality adjusted life years were significantly lower than that expected for the general population (P < 0.001).

Conclusions: Intensive care unit admission is associated with a high mortality, a poor physical quality of life and a low quality adjusted life years gained compared to the general population for 5 years after discharge. In this group, critical illness associated with ICU admission should be treated as a life time diagnosis with associated excess mortality, morbidity and the requirement for ongoing health care support.

Show MeSH