Effects of prolonged intensive care unit stay on quality of life and long-term survival after transthoracic esophageal resection

OBJECTIVE:There are few prospective data on the effects of prolonged intensive care unit stay on the quality of life and long-term survival of a homogeneous patient population. Therefore, the aims of this prospective study were a) to describe the quality of life in patients after having a transthora...

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Veröffentlicht in:Critical care medicine 2006-02, Vol.34 (2), p.354-362
Hauptverfasser: Cense, H A, Hulscher, J B. F, de Boer, A G. E. M, Dongelmans, D A, Tilanus, H W, Obertop, H, Sprangers, M A. G, van Lanschot, J J. B
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container_end_page 362
container_issue 2
container_start_page 354
container_title Critical care medicine
container_volume 34
creator Cense, H A
Hulscher, J B. F
de Boer, A G. E. M
Dongelmans, D A
Tilanus, H W
Obertop, H
Sprangers, M A. G
van Lanschot, J J. B
description OBJECTIVE:There are few prospective data on the effects of prolonged intensive care unit stay on the quality of life and long-term survival of a homogeneous patient population. Therefore, the aims of this prospective study were a) to describe the quality of life in patients after having a transthoracic esophageal resection; and b) to analyze the influences of a prolonged intensive care unit stay on quality of life and survival in patients after esophageal cancer resection who survived to hospital discharge. DESIGN:Prospective study. SETTING:Medical center. PATIENTS:The study population consisted of 109 patients undergoing a transthoracic resection for adenocarcinoma of the middistal esophagus or gastric cardia between April 1994 and February 2000. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:A comparison was made between patients staying ≤5 days vs. ≥6 days in the intensive care unit and also ≤2 days vs. ≥14 days. Quality of life was assessed in all patients by mailed self-report questionnaires at baseline (preoperatively), at 5 wks, and at 3, 6, 9, 12, 18, 24, 30, and 36 months after surgery. Daily physical, emotional, and social functioning was assessed with the generic Medical Outcome Studies Short Form-20. Disease-specific quality of life was measured by an adapted Rotterdam Symptom Check List. Quality of life data were gathered between July 1994 and March 2003. Five of the 109 patients died in the hospital and were excluded from the analysis. All five of them were in the intensive care unit ≥6 days. Of the remaining 104 patients, 92 provided baseline scores. The data of the 92 patients were used for the quality of life analyses. For the clinicopathologic and survival analysis, the data of 104 hospital survivors were used. Patients spent a median of 5.5 days (range 0–71) in the intensive care unit. The Medical Outcome Studies Short Form-20 and the Rotterdam Symptom Check List measurements showed no clear differences in long-term quality of life between patients after a short vs. a prolonged postoperative intensive care unit period. The median overall survival in all patients was 2.0 yrs (range 0.1–8.0). Median overall survival in patients staying in the intensive care unit ≤5 days was 1.9 yrs (range 0.3–7.4 yrs) vs. 2.7 yrs (range 0.9–7.2 yrs) in patients staying ≥6 days (p = .9, log-rank test). Median overall survival in patients staying in the intensive care unit ≤2 days was 1.7 yrs (range 1.2–2.6 yrs) vs. 2.0 yrs (range 0.2–3.8 yrs) in patients
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F ; de Boer, A G. E. M ; Dongelmans, D A ; Tilanus, H W ; Obertop, H ; Sprangers, M A. G ; van Lanschot, J J. B</creator><creatorcontrib>Cense, H A ; Hulscher, J B. F ; de Boer, A G. E. M ; Dongelmans, D A ; Tilanus, H W ; Obertop, H ; Sprangers, M A. G ; van Lanschot, J J. B</creatorcontrib><description>OBJECTIVE:There are few prospective data on the effects of prolonged intensive care unit stay on the quality of life and long-term survival of a homogeneous patient population. Therefore, the aims of this prospective study were a) to describe the quality of life in patients after having a transthoracic esophageal resection; and b) to analyze the influences of a prolonged intensive care unit stay on quality of life and survival in patients after esophageal cancer resection who survived to hospital discharge. DESIGN:Prospective study. SETTING:Medical center. PATIENTS:The study population consisted of 109 patients undergoing a transthoracic resection for adenocarcinoma of the middistal esophagus or gastric cardia between April 1994 and February 2000. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:A comparison was made between patients staying ≤5 days vs. ≥6 days in the intensive care unit and also ≤2 days vs. ≥14 days. Quality of life was assessed in all patients by mailed self-report questionnaires at baseline (preoperatively), at 5 wks, and at 3, 6, 9, 12, 18, 24, 30, and 36 months after surgery. Daily physical, emotional, and social functioning was assessed with the generic Medical Outcome Studies Short Form-20. Disease-specific quality of life was measured by an adapted Rotterdam Symptom Check List. Quality of life data were gathered between July 1994 and March 2003. Five of the 109 patients died in the hospital and were excluded from the analysis. All five of them were in the intensive care unit ≥6 days. Of the remaining 104 patients, 92 provided baseline scores. The data of the 92 patients were used for the quality of life analyses. For the clinicopathologic and survival analysis, the data of 104 hospital survivors were used. Patients spent a median of 5.5 days (range 0–71) in the intensive care unit. The Medical Outcome Studies Short Form-20 and the Rotterdam Symptom Check List measurements showed no clear differences in long-term quality of life between patients after a short vs. a prolonged postoperative intensive care unit period. The median overall survival in all patients was 2.0 yrs (range 0.1–8.0). Median overall survival in patients staying in the intensive care unit ≤5 days was 1.9 yrs (range 0.3–7.4 yrs) vs. 2.7 yrs (range 0.9–7.2 yrs) in patients staying ≥6 days (p = .9, log-rank test). Median overall survival in patients staying in the intensive care unit ≤2 days was 1.7 yrs (range 1.2–2.6 yrs) vs. 2.0 yrs (range 0.2–3.8 yrs) in patients staying ≥14 days (p = .74, log-rank test). CONCLUSIONS:For patients who survived to hospital discharge after transthoracic esophagectomy, there was no difference in long-term quality of life or survival between those submitted to the intensive care unit for a short period vs. a long period.</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/01.CCM.0000195016.55516.3E</identifier><identifier>PMID: 16424714</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: by the Society of Critical Care Medicine and Lippincott Williams &amp; Wilkins</publisher><subject>Activities of Daily Living ; Adenocarcinoma - mortality ; Adenocarcinoma - surgery ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Clinical death. Palliative care. Organ gift and preservation ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Esophageal Neoplasms - mortality ; Esophageal Neoplasms - surgery ; Female ; Health Status ; Humans ; Intensive care medicine ; Intensive Care Units ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Postoperative Period ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Survival Analysis ; Time Factors</subject><ispartof>Critical care medicine, 2006-02, Vol.34 (2), p.354-362</ispartof><rights>2006 by the Society of Critical Care Medicine and Lippincott Williams &amp; Wilkins</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4581-89d2a046a60acaee10b1080f4fdae4a20f3d653ed5015ffa4aad7b50bc205b703</citedby><cites>FETCH-LOGICAL-c4581-89d2a046a60acaee10b1080f4fdae4a20f3d653ed5015ffa4aad7b50bc205b703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=17474535$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16424714$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cense, H A</creatorcontrib><creatorcontrib>Hulscher, J B. F</creatorcontrib><creatorcontrib>de Boer, A G. E. M</creatorcontrib><creatorcontrib>Dongelmans, D A</creatorcontrib><creatorcontrib>Tilanus, H W</creatorcontrib><creatorcontrib>Obertop, H</creatorcontrib><creatorcontrib>Sprangers, M A. G</creatorcontrib><creatorcontrib>van Lanschot, J J. B</creatorcontrib><title>Effects of prolonged intensive care unit stay on quality of life and long-term survival after transthoracic esophageal resection</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVE:There are few prospective data on the effects of prolonged intensive care unit stay on the quality of life and long-term survival of a homogeneous patient population. Therefore, the aims of this prospective study were a) to describe the quality of life in patients after having a transthoracic esophageal resection; and b) to analyze the influences of a prolonged intensive care unit stay on quality of life and survival in patients after esophageal cancer resection who survived to hospital discharge. DESIGN:Prospective study. SETTING:Medical center. PATIENTS:The study population consisted of 109 patients undergoing a transthoracic resection for adenocarcinoma of the middistal esophagus or gastric cardia between April 1994 and February 2000. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:A comparison was made between patients staying ≤5 days vs. ≥6 days in the intensive care unit and also ≤2 days vs. ≥14 days. Quality of life was assessed in all patients by mailed self-report questionnaires at baseline (preoperatively), at 5 wks, and at 3, 6, 9, 12, 18, 24, 30, and 36 months after surgery. Daily physical, emotional, and social functioning was assessed with the generic Medical Outcome Studies Short Form-20. Disease-specific quality of life was measured by an adapted Rotterdam Symptom Check List. Quality of life data were gathered between July 1994 and March 2003. Five of the 109 patients died in the hospital and were excluded from the analysis. All five of them were in the intensive care unit ≥6 days. Of the remaining 104 patients, 92 provided baseline scores. The data of the 92 patients were used for the quality of life analyses. For the clinicopathologic and survival analysis, the data of 104 hospital survivors were used. Patients spent a median of 5.5 days (range 0–71) in the intensive care unit. The Medical Outcome Studies Short Form-20 and the Rotterdam Symptom Check List measurements showed no clear differences in long-term quality of life between patients after a short vs. a prolonged postoperative intensive care unit period. The median overall survival in all patients was 2.0 yrs (range 0.1–8.0). Median overall survival in patients staying in the intensive care unit ≤5 days was 1.9 yrs (range 0.3–7.4 yrs) vs. 2.7 yrs (range 0.9–7.2 yrs) in patients staying ≥6 days (p = .9, log-rank test). Median overall survival in patients staying in the intensive care unit ≤2 days was 1.7 yrs (range 1.2–2.6 yrs) vs. 2.0 yrs (range 0.2–3.8 yrs) in patients staying ≥14 days (p = .74, log-rank test). CONCLUSIONS:For patients who survived to hospital discharge after transthoracic esophagectomy, there was no difference in long-term quality of life or survival between those submitted to the intensive care unit for a short period vs. a long period.</description><subject>Activities of Daily Living</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - surgery</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Clinical death. Palliative care. Organ gift and preservation</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Esophageal Neoplasms - mortality</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Female</subject><subject>Health Status</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Intensive Care Units</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Postoperative Period</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Surveys and Questionnaires</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkV2PEyEUhonRuHX1LxhiondTDwPMdLwzTf1I1nij1-QMc9iidOjCTDe986dLt03KBYTwvJzDA2PvBCwFdO1HEMv1-scSyhCdBtEstdZllptnbCG0hArqTj5nC4AOKqk6ecNe5fyn4Eq38iW7EY2qVSvUgv3bOEd2yjw6vk8xxPGeBu7HicbsD8QtJuLz6CeeJzzyOPKHGYOfjqdA8I44jgM_xaqJ0o7nOR38AQNHV_Z8SjjmaRsTWm855bjf4j2V40S5lPVxfM1eOAyZ3lzWW_b7y-bX-lt19_Pr9_Xnu8oqvRLVqhtqBNVgA2iRSEAvYAVOuQFJYQ1ODo2WNBQf2jlUiEPba-htDbpvQd6yD-d7yysfZsqT2flsKQQcKc7ZtNCsZGEL-OkM2hRzTuTMPvkdpqMRYE7-DQhT_Jurf_Pk38hNCb-9VJn7HQ3X6EV4Ad5fAMwWgyt-rM9XrlWt0vLUhTpzjzEUkflvmB8pmW1xN22fSstaNVUN0ECZypeXZoT8D_zgoPg</recordid><startdate>200602</startdate><enddate>200602</enddate><creator>Cense, H A</creator><creator>Hulscher, J B. 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Coronary intensive care</topic><topic>Esophageal Neoplasms - mortality</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Female</topic><topic>Health Status</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Postoperative Period</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Surveys and Questionnaires</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cense, H A</creatorcontrib><creatorcontrib>Hulscher, J B. F</creatorcontrib><creatorcontrib>de Boer, A G. E. M</creatorcontrib><creatorcontrib>Dongelmans, D A</creatorcontrib><creatorcontrib>Tilanus, H W</creatorcontrib><creatorcontrib>Obertop, H</creatorcontrib><creatorcontrib>Sprangers, M A. G</creatorcontrib><creatorcontrib>van Lanschot, J J. B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cense, H A</au><au>Hulscher, J B. F</au><au>de Boer, A G. E. M</au><au>Dongelmans, D A</au><au>Tilanus, H W</au><au>Obertop, H</au><au>Sprangers, M A. G</au><au>van Lanschot, J J. B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of prolonged intensive care unit stay on quality of life and long-term survival after transthoracic esophageal resection</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>2006-02</date><risdate>2006</risdate><volume>34</volume><issue>2</issue><spage>354</spage><epage>362</epage><pages>354-362</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVE:There are few prospective data on the effects of prolonged intensive care unit stay on the quality of life and long-term survival of a homogeneous patient population. Therefore, the aims of this prospective study were a) to describe the quality of life in patients after having a transthoracic esophageal resection; and b) to analyze the influences of a prolonged intensive care unit stay on quality of life and survival in patients after esophageal cancer resection who survived to hospital discharge. DESIGN:Prospective study. SETTING:Medical center. PATIENTS:The study population consisted of 109 patients undergoing a transthoracic resection for adenocarcinoma of the middistal esophagus or gastric cardia between April 1994 and February 2000. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:A comparison was made between patients staying ≤5 days vs. ≥6 days in the intensive care unit and also ≤2 days vs. ≥14 days. Quality of life was assessed in all patients by mailed self-report questionnaires at baseline (preoperatively), at 5 wks, and at 3, 6, 9, 12, 18, 24, 30, and 36 months after surgery. Daily physical, emotional, and social functioning was assessed with the generic Medical Outcome Studies Short Form-20. Disease-specific quality of life was measured by an adapted Rotterdam Symptom Check List. Quality of life data were gathered between July 1994 and March 2003. Five of the 109 patients died in the hospital and were excluded from the analysis. All five of them were in the intensive care unit ≥6 days. Of the remaining 104 patients, 92 provided baseline scores. The data of the 92 patients were used for the quality of life analyses. For the clinicopathologic and survival analysis, the data of 104 hospital survivors were used. Patients spent a median of 5.5 days (range 0–71) in the intensive care unit. The Medical Outcome Studies Short Form-20 and the Rotterdam Symptom Check List measurements showed no clear differences in long-term quality of life between patients after a short vs. a prolonged postoperative intensive care unit period. The median overall survival in all patients was 2.0 yrs (range 0.1–8.0). Median overall survival in patients staying in the intensive care unit ≤5 days was 1.9 yrs (range 0.3–7.4 yrs) vs. 2.7 yrs (range 0.9–7.2 yrs) in patients staying ≥6 days (p = .9, log-rank test). Median overall survival in patients staying in the intensive care unit ≤2 days was 1.7 yrs (range 1.2–2.6 yrs) vs. 2.0 yrs (range 0.2–3.8 yrs) in patients staying ≥14 days (p = .74, log-rank test). CONCLUSIONS:For patients who survived to hospital discharge after transthoracic esophagectomy, there was no difference in long-term quality of life or survival between those submitted to the intensive care unit for a short period vs. a long period.</abstract><cop>Hagerstown, MD</cop><pub>by the Society of Critical Care Medicine and Lippincott Williams &amp; Wilkins</pub><pmid>16424714</pmid><doi>10.1097/01.CCM.0000195016.55516.3E</doi><tpages>9</tpages></addata></record>
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subjects Activities of Daily Living
Adenocarcinoma - mortality
Adenocarcinoma - surgery
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Clinical death. Palliative care. Organ gift and preservation
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Esophageal Neoplasms - mortality
Esophageal Neoplasms - surgery
Female
Health Status
Humans
Intensive care medicine
Intensive Care Units
Length of Stay
Male
Medical sciences
Middle Aged
Postoperative Period
Prospective Studies
Quality of Life
Surveys and Questionnaires
Survival Analysis
Time Factors
title Effects of prolonged intensive care unit stay on quality of life and long-term survival after transthoracic esophageal resection
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