Long-stay medical-surgical intensive care unit patients in South Africa : quality of life and mortality 1 year after discharge

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dc.contributor.author Van der Merwe, E.
dc.contributor.author Baker, D.
dc.contributor.author Sharp, G.
dc.contributor.author Van Niekerk, M.
dc.date.accessioned 2022-11-28T13:00:33Z
dc.date.available 2022-11-28T13:00:33Z
dc.date.issued 2022-03
dc.description.abstract BACKGROUND. Although mortality is the primary measure of critical care outcome, the health-related quality of life (HRQOL) of survivors is often diminished. There is a paucity of South African research on HRQOL in intensive care unit (ICU) survivors. OBJECTIVES. To evaluate the 1-year post-discharge data of long-stay ICU patients, a group known to consume 20 - 40% of ICU resources. METHODS. A 1-year prospective observational study was conducted in a multidisciplinary medical-surgical ICU. Adult patients who were mechanically ventilated beyond 6 days were included. Clinical and mortality data were collected. Pre-admission and 6- and 12-month HRQOL were measured with the Short Form-36 questionnaire. Physical and mental component summary scores (PCS and MCS) were calculated. Associations between 12-month mortality and poor HRQOL scores were determined. RESULTS. Of 119 patients enrolled, 40.3% had sustained trauma, 19.3% were post-surgical and 40.3% had medical conditions; 29.2% were HIV-positive (HIV status was known for 74.8% of the cohort). The hospital and 12-month mortality rates were 42.9% and 57.4% (n=66/115), respectively. Age, longer ICU stay, higher disease severity scores and vasopressor use were associated with 12-month mortality. The survivors’ median PCS and MCS at 6 and 12 months were significantly lower compared with pre-admission scores (both p<0.001). At 12 months, 53.1% of survivors demonstrated a poor PCS and 42.9% a poor MCS. Associations with poor 12-month PCS included longer ICU stay, male gender and trauma, while trauma and sepsis were associated with a poor 12-month MCS. Among the 19 trauma survivors, 78.9% had a poor MCS and/or PCS. Of previously employed patients, 54.8% were unemployed at 12 months. CONCLUSIONS. Patients ventilated beyond 6 days in a multidisciplinary ICU had a high mortality. Poor HRQOL at 12 months post discharge was frequently observed among survivors. Trauma was associated with poor 12-month outcomes. These findings highlight the need to further explore the outcomes of long-stay ICU patients in Africa. en_US
dc.description.department Critical Care en_US
dc.description.librarian dm2022 en_US
dc.description.sponsorship South African Critical Care Society research grant. en_US
dc.description.uri http://www.samj.org.za en_US
dc.identifier.citation Van der Merwe, E., Baker, D., Sharp, G., et al. Long-stay medical-surgical intensive care unit patients in South Africa: Quality of life and mortality 1 year after discharge. South African Medical Journal, vol. 112, no. 3, pp. 227-233, mar. 2022, doi : 0.7196/SAMJ.2022.v112i3.16191. en_US
dc.identifier.issn 2078-5135 (online)
dc.identifier.issn 0256-9574 (print)
dc.identifier.other 10.7196/SAMJ.2022.v112i3.16191
dc.identifier.uri https://repository.up.ac.za/handle/2263/88497
dc.language.iso en en_US
dc.publisher Health and Medical Publishing Group en_US
dc.rights This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. en_US
dc.subject Mortality en_US
dc.subject South Africa (SA) en_US
dc.subject Critical care en_US
dc.subject Health-related quality of life (HRQOL) en_US
dc.subject Intensive care unit (ICU) en_US
dc.subject Long-stay ICU patients en_US
dc.title Long-stay medical-surgical intensive care unit patients in South Africa : quality of life and mortality 1 year after discharge en_US
dc.type Article en_US


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