• Journal of critical care · Dec 2018

    Multicenter Study

    Patients' perceptions and ICU clinicians predictions of quality of life following critical illness.

    • Michael E Detsky, Rachel Kohn, Aaron M Delman, Anna E Buehler, Saida A Kent, Isabella V Ciuffetelli, Mark E Mikkelsen, Alison E Turnbull, and Michael O Harhay.
    • Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Sinai Health System, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: michael.detsky@sinaihealthsystem.ca.
    • J Crit Care. 2018 Dec 1; 48: 352-356.

    PurposeTo determine how patients perceive their quality of life (QOL) six months following critical illness and to measure clinicians' discriminative accuracy of predicting this outcome.Materials And MethodsThis prospective cohort study of intensive care unit (ICU) survivors asked patients to report their QOL strictly at six months compared to one month before their critical illness as better, the same, or worse. ICU physicians and nurses made six-month QOL predictions for these patients.ResultsOf 162 critical illness survivors, 33% (n = 53) of patients reported six-month QOL as better, 33% (n = 54) the same, and 34% (n = 55) worse. Abnormal cognition and inability to return to primary pastime or original place of residence (p < .05 for all) were associated with worse self-reported QOL at six months in multivariable regression. Predictions of patient perceptions of QOL at six months were pessimistic and had low discriminative accuracy for both physicians (sensitivity 56%, specificity 53%) and nurses (sensitivity 49%, specificity 57%).ConclusionsAmong survivors of critical illness, one-third each reported their six-month post-ICU QOL as better, the same, or worse. Self-reported six-month QOL was associated with six-month function. ICU clinicians should use caution in predicting self-reported QOL, as discriminative accuracy was poor in this cohort.Copyright © 2018 Elsevier Inc. All rights reserved.

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