Quality of life in the five years after intensive care a cohort study 英文参考文献.docVIP

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Quality of life in the five years after intensive care a cohort study 英文参考文献.doc

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Quality of life in the five years after intensive care a cohort study 英文参考文献

Cuthbertsonetal.CriticalCare2010,14:R6 /content/14/1/R6 RESEARCH OpenAccess Qualityoflifeinthefiveyearsafterintensive care:acohortstudy BrianHCuthbertson1*,SianRoughton2,DavidJenkinson3,GraemeMacLennan3,LukeVale2,4 Abstract Introduction:Dataonqualityoflifebeyond2yearsafterintensivecaredischargearelimitedandweaimedto explorethisareafurther.Ourobjectivewastoquantifyqualityoflifeandhealthutilitiesinthe5yearsafter intensivecaredischarge. Methods:AprospectivelongitudinalcohortstudyinaUniversityHospitalintheUK.Qualityoflifewasassessed fromtheperiodbeforeICUadmissionuntil5yearsandqualityadjustedlifeyearscalculated. Results:300level3intensivecarepatientsofmedianage60.5yearsandmedianlengthofstay6.7days,were recruited.Physicalqualityoflifefellto3months(P=0.003),rosebacktopre-morbidlevelsat12monthsthenfell againfrom2.5to5yearsafterintensivecare(P=0.002).Meanphysicalscoreswerebelowthepopulationnormat alltimepointsbutthemeanmentalscoresafter6monthsweresimilartothosepopulationnorms.Theutility valuemeasuredusingtheEuroQOL-5Dqualityoflifeassessmenttool(EQ-5D)at5yearswas0.677.Duringthefive yearsafterintensivecareunit,thecumulativequalityadjustedlifeyearsweresignificantlylowerthanthatexpected forthegeneralpopulation(P0.001). Conclusions:Intensivecareunitadmissionisassociatedwithahighmortality,apoorphysicalqualityoflifeanda lowqualityadjustedlifeyearsgainedcomparedtothegeneralpopulationfor5yearsafterdischarge.Inthisgroup, criticalillnessassociatedwithICUadmissionshouldbetreatedasalifetimediagnosiswithassociatedexcess mortality,morbidityandtherequirementforongoinghealthcaresupport. Introduction psychologicalandcognitivedysfunctionthatareknown Intensivecaremanagementisassociatedwithsignificant tolastforatleasttwoyearsafterICUdischarge[10-12]. morbidity and mortality as well as a huge health care Currently,thereisasmallandlimitedevidencebaseon expenditure in developed countries [1,2]. Expenditure thecost-effectivenessofICUcarebutthelimitedresults varies markedly between developed