Turkish Journal of Physical Medicine and Rehabilitation

Worse pre-admission quality of life is a strong predictor of mortality in critically ill patients

Ezgi Özyılmaz 1 ,Özlem Özkan Kuşçu 2 ,Emre Karakoç 3 ,Aslı Boz 4 ,Gülşah Orhan Tıraşçı 1 ,Rengin Güzel 5 ,Gülşah Seydaoğlu 4
1 Department of Chest Disease and Intensive Care Unit, Çukurova University Faculty of Medicine, Adana, Turkey
2 Department of Intensive Care Unit, Seyhan State Hospital, Adana, Turkey
3 Department of Internal Medicine and Intensive Care Unit, Çukurova University Faculty of Medicine, Adana, Turkey
4 Department of Biostatistics, Çukurova University Faculty of Medicine, Adana, Turkey
5 Department of Physical Medicine and Rehabilitation, Çukurova University Faculty of Medicine, Adana, Turkey
DOI : 10.5606/tftrd.2022.5287 Objectives: In this study, we aimed to investigate whether quality of life (QoL) before intensive care unit (ICU) admission could predict ICU mortality in critically ill patients.

Patients and methods: Between January 2019 and April 2019, a total of 105 ICU patients (54 males, 51 females; mean age: 58 years; range, 18 to 91 years) from two ICUs of a tertiary care hospital were included in this cross-sectional, prospective study. Pre-admission QoL was measured by the Short Form (SF)-12- Physical Component Scores (PCS) and Mental Component Scores (MCS) and EuroQoL five-dimension, five-level scale (EQ-5D-5L) within 24 h of ICU admission and mortality rates were estimated.

Results: The overall mortality rate was 28.5%. Pre-admission QoL was worse in the non-survivors independent from age, sex, socioeconomic and education status, and comorbidities. During the hospitalization, the rate of sepsis and ventilator/hospital-acquired pneumonia were similar among the two groups (p>0.05). Logistic regression analysis adjusted for sex, age, education status, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores showed that pre-admission functional status as assessed by the SF-12 MCS (odds ratio [OR]: 14,2; 95% confidence interval [CI]: 2.5-79.0), SF-12 PCS (OR: 10.6; 95% CI: 1.8-62.7), and EQ-5D-5L (OR: 8.0; 95% CI: 1.5-44.5) were found to be independently associated with mortality.

Conclusion: Worse pre-admission QoL is a strong predictor of mortality in critically ill patients. The SF-12 and EQ-5D-5L scores are both valuable tools for this assessment. Not only the physical status, but also the mental status before ICU admission should be evaluated in terms of QoL to better utilize ICU resources. Keywords : EQ5D5L scores, intensive care unit, preadmission, prognosis, quality of life analysis, short form-12