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[Variations in health-related quality of life in critical patients]
S Iribarren-Diarasarri1, F Aizpuru-Barandiaran, T Muñoz-Martínez
1Unidad de Medicina Intensiva. Hospital Txagorritxu. Vitoria. Alava. España. SEBASTIAN.IRIBARRENDIARASARRI@osakidetza.net
Objective:
To determine the changes in the health-related quality of life (hRQOL) six months after discharge from the ICU and the conditions associated to them.
Design:
A prospective cohort study.
Setting:
14 beds medical-surgical intensive care unit (ICU).
Patients:
A total of 247 patients admitted to our ICU for more than 24 hours with a follow-up of 6 months were study. Those admitted with acute coronary syndrome or for monitoring purposes were excluded.
Intervention:
A quality of life survey was conducted using the score developed by the PAEEC group (project of the epidemiological analysis of critical illness) to assess hRQOL before ICU admission and 6 months after discharge.
Results:
The hRQOL deteriorated, going from a median value of 3 to 6 (p < 0.001). The multivariate analysis showed less deterioration of hRQOL in patients with chronic health conditions registered on the APAChE-II score (regression coefficient [RC] = -1.4; 95% CI, -2.5 to -0.2; p < 0.02) and in those with a hRQOL > or = 10 points (RC = -4,4; 95% CI, -5.9 to -2.8; p < 0.001). There was more deterioration in polytraumatized patients (RC = 1.9; 95% CI, 0.6-3.3; p = 0.01) or with renal failure (RC = 3.9; 95% CI, 1.9-5.9; p < 0.001) or in those with a stay duration longer than 10 days (RC = 1.9; 95% CI, 0.6-3.2; p < 0.001).
Conclusions:
Most patients experience deterioration of hRQOL. Patients with chronic diseases or with worst previous hRQOL who survive 6 months experience less deterioration of hRQOL than those who are polytraumatized or have renal failure or a longer ICU stay.
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