Impact of Critical Illness on Quality of Life after Intensive Care Unit Discharge

Richa Rai; Ritu Singh; Afzal Azim; Arti Agarwal; Prabhakar Mishra; Prabhat K Singh

doi:10.5005/jp-journals-10071-23433

Impact of Critical Illness on Quality of Life after Intensive Care Unit Discharge

Indian J Crit Care Med. 2020 May;24(5):299-306. doi: 10.5005/jp-journals-10071-23433.

Authors

Richa Rai¹, Ritu Singh², Afzal Azim³, Arti Agarwal¹, Prabhakar Mishra³, Prabhat K Singh¹

Affiliations

¹ Department of Anesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
² Department of Anesthesia and Critical Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
³ Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Abstract

Objective: To assess the quality of life (QoL) following intensive care unit (ICU) discharge using 6 months' prospective follow-up and to analyze the risk factors affecting quality-of-life post-discharge.

Design: A prospective observational cohort study. Conducted on adult patients, discharged from ICU after more than 7 days' stay. Study duration is from January 2017 to October 2018. Patients <18 years, nonconsenting, preexisting neurological illness, and lost to follow-up were excluded. Follow-up was done at 1 and 6 months using the SF-36 questionnaire. The pre-ICU functional status, patient demographics, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHE II) score, New York Health Evaluation (NYHA) classification, and details of ICU stay were collected.

Results: One hundred patients (M = 60, F = 40) with ICU stay (13.64 ± 3.75 days), days of mechanical ventilation (7.93 ± 3.89 days), admission APACHE II (18.88 ± 4.34) and SOFA (7.73 ± 1.54) scores. Comparison showed physical component summary (PCS) score and mental component summary (MCS) score at pre-ICU were 55.12 and 55.09 which decreased to 39.59 and 35.49 (p < 0.05) at 1 month post-discharge and 47.93 and 37.46 at 6 months. Age, APACHE II, and SOFA scores are the significant factors affecting PCS and MCS. Length of ICU stay and duration of mechanical ventilation did not affect significantly at 6 months. When compared with general population PCS and MCS showed significant deterioration at 1 and 6 months.

Conclusion: Post-ICU discharge patients have significant functional impairment and compromised health-related QoL (HRQoL). Age and severity of illness significantly affects health quality parameters and decline is below the normal data of general population.

How to cite this article: Rai R, Singh R, Azim A, et al. Impact of Critical Illness on Quality of Life after Intensive Care Unit Discharge. Indian J Crit Care Med 2020;24(5):299-306.

Keywords: Acute physiology and chronic health evaluation II; Critical illness; Quality of Life.