The following is a summary of “Is comorbidity alone responsible for changes in health-related quality of life among critical care survivors? A purpose-specific review,” published in the June 2024 issue of Critical Care by Orwelius et al.

The HRQoL is a crucial measure of ICU effectiveness, but the extent of its impact, apart from comorbidities, still needs to be explored.

Researchers conducted a retrospective study investigating the independent effect of a general ICU stay on HRQoL in patients with critical illness beyond the influence of pre-existing comorbidities.

They conducted a comprehensive literature review to identify relevant studies published (2010 to 2021), searching major academic databases including PubMed, CINAHL, Scopus, and the Cochrane Library.

The result showed HRQoL in adult ICU (≥ 18 years), including patients who stayed in the ICU for more than 24 hours, and measured HRQoL more than 30 days after discharge, using either the SF-36 or EQ-5D questionnaires. The HRQoL results were adjusted for age or pre-existing comorbidities. A total of 11 publications were identified, of which the majority were observational prospective cohort studies, while three were case-control, cross-sectional comparison, or retrospective cohort studies. The studies included data from 18,566 patients with critical illness. The proportion of patients who responded to the HRQoL surveys varied considerably across the studies, ranging from 16% to 94%. Consistently across the studies, pre-ICU comorbidities significantly impacted HRQoL after ICU care. Interestingly, three studies that compared ICU survivors to a control group with similar comorbidities found no additional effect of critical care itself on HRQoL.

Investigators concluded that comorbidities seemed to be the main factor affecting long-term well-being in survivors of ICUs, highlighting the need for more standardized research in this area.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04997-x