Demand and consumption of care in long term ICU survivors in the netherlands

Objective: To study the long-term impact of critical illness on demand and consumption of care after hospital discharge. Methods: In a prospective study all patients admitted to the ICU for > 48 hours who ultimately survived to follow up at six months were included. The Short Form 36 (SF-36) was used to evaluate the health-related quality of life (HRQOL) 6 months following ICU discharge. Additionally, consumption of medical care was analysed by querying survivors. Severity of illness was determined using the APACHE II score. Results: Of the 451 patients included, 252 were evaluated at 6 months. 64.6% of the patients were older than 65 years, 90.9% of the patients were living at home, although 66% of the patients who were employed before ICU admission did not resume their job. Eighty patients (31.7%) were still depending on professional help for medical care, more than half of them on a daily basis. Conclusions: Most long-term ICU survivors are discharged to their own home and are six months after ICU discharge frequently still dependent on complex care, as impairment occurs not only on a physical level, but also in psychological and social domains, probably related to a higher incidence of isolation from normal life. The burden of ICU stay seems substantial and long-lasting. This is not only important for patients and their relatives but also for care providers and society.