Survival and health related quality of life of patients 12 months following discharge from an adult surgical intensive care unit
Thesis (MScPhysio(Interdisciplinary Health Sciences. Physiotherapy))--University of Stellenbosch, 2005.
Objectives: This study forms part of a baseline study conducted on patients admitted to an adult surgical ICU between June and October 2003. The survival rate and health related quality of life (HRQoL) of patients 12months following ICU discharge was determined. The correlation of selected demographic and ICU variables to survival and HRQoL was determined. Design: Prospective observational cohort study. Setting: Tenbed closed public tertiary adult surgical ICU. Patients: 180 subjects obtained from a previous baseline study. Measurements: The baseline study provided the demographic data and ICU variables. Survival rate was determined from a Kaplan Meier survival curve. A self-developed questionnaire was used to obtain other selected variables for comparison. A modified Short-Form 36 version 2 (SF-36v2) was use to measure HRQoL perceptions of patients. Results: The survival rate was 62% at 12 months following ICU admission. None of the selected variables were significantly correlated to the long-term survival outcome except for APACHE II which was negatively correlated to this outcome (p<0.01). Forty-six subjects took part in the HRQoL study. The mean HRQoL scores ranged between 43% and 53% for each of the SF-36 HRQoL domains. The physical functioning (43.5%), role play (44.5%) and role emotion (43.1%) domains had the lowest scores. APACHE II had a significantly negative correlation to the physical functioning domain of HRQoL (p=0.02). Age was positively correlated to social functioning (p<0.01) and role emotion (p=0.03). Patients employed after ICU had significantly higher scores for general health (p<0.01) than those who were not. Patients unsure of their TB status and HIV status had significantly lower scores in general health (p=0.02) and role emotion (p=0.05) respectively. ICU length of stay was negatively correlated to role play (p=0.05) and role emotion (p<0.01). Intubation period was negatively correlated to general health (p=0.04). Conclusion: APACHE II was the only variable significantly correlated to both long-term survival and the physical functioning domain of HRQoL. Although the long-term survival was comparable to that of international ICU populations the HRQoL outcomes were slightly lower. Similar to international studies and a South African study evaluating the HRQoL of aids sufferers and police, the current ICU population presented more limitation in the physical functioning, role play and role emotion domains of HRQoL.