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 Turnbull, Michael O. Harhay

Research output: Contribution to journalArticle

Abstract

Purpose: To 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 methods: This 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. Results: Of 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%). Conclusions: Among 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.

Original languageEnglish (US)
Pages (from-to)352-356
Number of pages5
JournalJournal of Critical Care
Volume48
DOIs
StatePublished - Dec 1 2018

Keywords

  • Critical illness
  • Functional status
  • Long-term outcomes
  • Quality of life
  • Survival

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Detsky, M. E., Kohn, R., Delman, A. M., Buehler, A. E., Kent, S. A., Ciuffetelli, I. V., Mikkelsen, M. E., Turnbull, A., & Harhay, M. O. (2018). Patients' perceptions and ICU clinicians predictions of quality of life following critical illness. Journal of Critical Care, 48, 352-356. https://doi.org/10.1016/j.jcrc.2018.09.034