Anesteziyoloji ve Reanimasyon Yoğun Bakım Ünitesinde Izlenen Hastaların Yatış Öncesi ve Sonrası Yaşam Kalitelerinin Değerlendirilmesi

Abstract

A wide spectrum of critically ill patients with medical and surgical problems undergo treatment in intensive care units (ICU). Physicians have recently been forced to validate expenditure in the ICU which has been the cause for interest in investigating quality of life of patients after ICU stay in addition to such quality measures as mortality. Furthermore, such studies have led the way to interventions for improving quality in the ICU. The aim of this study is to compare the quality of life of patients before and one year after ICU stay. Sixty-six patients greater than 18 years of age, with an ICU stay of more than 24 hours, who were able to be discharged from the ICU or another hospital unit and who agreed to participate in the study were enrolled between May 1, 2011 and October 31, 2011. Patients were administered the Short form 36 (SF 36) questionnaire on the first day of admission with help from an investigator. In addition, demographic properties, co-morbidities, length of stay, and APACHE scores of all patients were recorded. Patients were contacted via telephone by an investigator one year after their stay and the SF 36 questionnaire was re-administered. The eight subcategories of health measured by the SF 36 questionnaire were scored for both before and one year after ICU stay, using the RAND Corporation guide for scoring the SF 36. Patients were divided into subgroups (follow-up after interventional radiological procedures and other indications for ICUstay patients) and the quality of life before and one year after ICU stay were compared within each group. In general patients demonstrated an improvement in all subcategories measured by the SF 36 questionnaire. Within these parameters, the improvement in physical role functioning, pain, social function, emotional role limitations and mental health were statistically significant. v Comparison of quality of life before and one year after ICU stay within groups demonstrated an improvement in emotional and mental subcategories in patients admitted for follow-up after interventonal radiological procedures. Within these parameters, the improvement in general health, social function, emotional role limitations and mental health were statistically significant. Comparison of quality of life before and one year after ICU stay in patients admitted for other indications to the ICU demonstrated a statistically significant improvement in physical and emotional role limitations, pain, and mental health. In conclusion, the effect of ICU stay on patients’ quality of life depends on many factors such as reasons for admission, presence of co-morbidities, length of stay and treatment modalities. It is the responsibility of the intensivist to develop approaches for improving quality in the ICU in order to decrease the traumatic effect of the ICU stay. Studies towards this goal will surely improve quality in the ICU and therefore the quality of life of patients after ICU stay.