Long-stay medical-surgical intensive care unit patients in South Africa: Quality of life and mortality 1 year after discharge

• Published in: South African medical journal 2022-03, Vol.112 (3), p.227-233
• Main Authors: van der Merwe, E, Baker, D, Sharp, G, van Niekerk, M, Paruk, F
• Format: Article
• Language: English
• Subjects: Health aspects; Hospital patients; Hospital utilization; Length of stay; Patient outcomes; Quality of life; Statistics; Surgical intensive care
• ISSN: 0256-9574; 2078-5135
• DOI: 10.7196/SAMJ.2022.v112i3.16191

Background Although mortality is the primary measure of critical care outcome, the health-related quality of life (HRQOL) of survivors is often diminished. There is a paucity of South African research on HRQOL in intensive care unit (ICU) survivors.Objectives To evaluate the 1-year post-discharge data of long-stay ICU patients, a group known to consume 20 - 40% of ICU resources.Methods A 1-year prospective observational study was conducted in a multidisciplinary medical-surgical ICU. Adult patients who were mechanically ventilated beyond 6 days were included. Clinical and mortality data were collected. Pre-admission and 6- and 12-month HRQOL were measured with the Short Form-36 questionnaire. Physical and mental component summary scores (PCS and MCS) were calculated. Associations between 12-month mortality and poor HRQOL scores were determined.Results Of 119 patients enrolled, 40.3% had sustained trauma, 19.3% were post-surgical and 40.3% had medical conditions; 29.2% were HIV-positive (HIV status was known for 74.8% of the cohort). The hospital and 12-month mortality rates were 42.9% and 57.4% (n=66/115), respectively. Age, longer ICU stay, higher disease severity scores and vasopressor use were associated with 12-month mortality. The survivors’ median PCS and MCS at 6 and 12 months were significantly lower compared with pre-admission scores (both p