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
Hauptverfasser: Wubben, Nina, van den Boogaard, Mark, Ramjith, Jordache, Bisschops, Laurens L.A., Frenzel, Tim, van der Hoeven, Johannes G., Zegers, Marieke
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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.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2021.04.019