Employment, social dependency and return to work after intensive care

Quality of life is an important measure of outcome in intensive care survivors. As return to employment is a key determinant of quality of life, we performed a prospective observational, cohort study of 75 intensive care unit patients who survived to hospital discharge. Approximately 2 years after intensive care unit discharge, 64% (18/28) of those employed before intensive care unit had returned to work. Of the rest, 10 were not working, two were unemployed, one was temporarily sick and seven were permanently sick. When health utility scores were assessed in the various employment categories, quality of life was particularly poor in the unemployed and permanently sick with median (interquartile range) scores of 0.082(-0.045-0.665) and 0.053(-0.160-0.769) respectively. Of the retired population, 95% returned to their own home with 50% requiring a family member to act as their carer. This study has demonstrated that patients who returned to work after a critical illness had a better quality of life at follow up, compared to the unemployed and permanently sick. In addition, there may be a burden on family members who act as carers for their relatives on discharge from hospital after a critical illness. Further work is required in this important area.