Development of a practically usable prediction model for quality of life of ICU survivors: A sub-analysis of the MONITOR-IC prospective cohort study
As the goal of ICU treatment is survival in good health, we aimed to develop a prediction model for ICU survivors' change in quality of life (QoL) one year after ICU admission. This is a sub-study of the prospective cohort MONITOR-IC study. Adults admitted ≥12 h to the ICU of a university hospi...
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Veröffentlicht in: | Journal of critical care 2021-10, Vol.65, p.76-83 |
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Sprache: | eng |
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Zusammenfassung: | As the goal of ICU treatment is survival in good health, we aimed to develop a prediction model for ICU survivors' change in quality of life (QoL) one year after ICU admission.
This is a sub-study of the prospective cohort MONITOR-IC study. Adults admitted ≥12 h to the ICU of a university hospital between July 2016–January 2019 were included. Moribund patients were excluded. Change in QoL one year after ICU admission was quantified using the EuroQol five-dimensional (EQ-5D-5L) questionnaire, and Short-Form 36 (SF-36). Multivariable linear regression analysis and best subsets regression analysis (SRA) were used. Models were internally validated by bootstrapping.
The PREdicting PAtients' long-term outcome for Recovery (PREPARE) model was developed (n = 1308 ICU survivors). The EQ-5D-models had better predictive performance than the SF-36-models. Explained variance (adjusted R2) of the best model (33 predictors) was 58.0%. SRA reduced the number of predictors to 5 (adjusted R2 = 55.3%, SE = 0.3), including QoL, diagnosis of a Cardiovascular Incident and frailty before admission, sex, and ICU-admission following planned surgery.
Though more long-term data are needed to ascertain model accuracy, in future, the PREPARE model may be used to better inform and prepare patients and their families for ICU recovery.
•There is a lack of patient-reported long-term outcome information in the ICU.•This causes a dependence on clinical experience and intuition for ICU decision-making.•We have developed a prediction model for change in QoL one year after ICU-admission that only needs 5 predictors.•Individualized information about long term quality of life enriches ICU physicians’ knowledge.•It also empowers ICU-patients to better manage their disease during ICU-stay and recovery and rehabilitation. |
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ISSN: | 0883-9441 1557-8615 |
DOI: | 10.1016/j.jcrc.2021.04.019 |