Health-related quality of life after mechanical ventilation in the intensive care unit

• Published in: Der Anaesthesist 2017-04, Vol.66 (4), p.240-248
• Main Authors: Schädler, D, Kaiser, L, Malchow, B, Becher, T, Elke, G, Frerichs, I, Küchler, T, Weiler, N
• Format: Article
• Language: ger
• Subjects: Aged; Aged, 80 and over; Clinical Protocols; Critical Care - psychology; Critical Illness; Female; Germany; Humans; Intensive Care Units; Male; Middle Aged; Quality of Life; Respiration, Artificial - psychology; Surveys and Questionnaires; Treatment Outcome; Ventilator Weaning
• ISSN: 1432-055X
• DOI: 10.1007/s00101-017-0276-6

It is unknown whether health related quality of life measured in German patients one year after mechanical ventilation in the intensive care unit is impaired or not. The aim of this study was to assess health related quality of life one year after inclusion into a randomized controlled trial for weaning from mechanical ventilation with the help of a questionnaire that has never been used in critically ill patients and to investigate whether health related quality of life scores differ between the study population and a general German population. We followed up with patients one year after inclusion into a randomized control trial investigating the effect of SmartCare/PS on total ventilation time compared to protocol-driven weaning (ASOPI trial, clinicaltrials.gov ID00445289). Health related quality of life was measured using the quality of life questionnaire C‑30 version 3.0 from the European Organization of Research and Treatment of Cancer (EORTC). Mean differences of at least 10 score points in the quality of life scales were considered clinically significant. Of the 232 patients who were alive 90 days after study inclusion, 24 patients died one year after study inclusion and 64 patients were lost to follow-up. Of the remaining145 patients who were successfully contacted, 126 patients agreed to fill out the questionnaire. Questionnaires were sent back to the study site by 83 patients and these were analyzed. Health-related quality of life was significantly lower in five of the six functional scales (physical functioning, role functioning, cognitive functioning, social functioning, global health status) and in eight of the nine symptom scales (fatigue, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties) compared to the reference values of a German normal population. The EORTC QLQ-C30 questionnaire is suitable for the acquisition of the health-related quality of life in formerly critically ill patients. Health-related quality of life is severely impaired after mechanical ventilation in the intensive care unit. Future studies should consider health related quality of life as a possible study endpoint.