Health-related quality of life in older patients surviving ICU treatment for COVID-19: results from an international observational study of patients older than 70 years
Ivo W. Soliman, Susannah Leaver, Hans Flaatten, Jesper Fjølner, Bernhard Wernly, Raphael R Bruno, Antonio Artigas, Bernardo Bollen Pinto, Joerg C. Schefold, Michael Beil, Sigal Sviri, Peter Vernon van Heerden, Wojciech Szczeklik, Muhammed Elhadi, Michael Joannidis, Sandra Oeyen, Tilemachos Zafeiridis, Jakob Wollborn, María José Arche Banzo, Kristina Fuest, Brian Marsh, Finn H. Andersen, Rui P. Moreno, Ariane Boumendil, Bertrand Guidet, Christian Jung, Dylan W. de Lange, The COVIP-study group, Philipp Eller, Michael Joannidis, Dieter Mesotten, P. Reper, Sandra Oeyen, Walter Swinnen, Helene Brix, Jens Brushoej, Maja Villefrance, Helene Korvenius Nedergaard, Anders Thais Bjerregaard, Ida Riise Balleby, Kasper H. Andersen, Maria Aagaard Hansen, Stine Uhrenholt, Helle Bundgaard, Jesper Fjølner, Aliae Ar Hussein Mohamed, Rehab Salah, Yasmin Khairy NasrEldin Mohamed Ali, Kyrillos Wassim, Yumna A Elgazzar, Samar Tharwat, Ahmed Y. Azzam, Ayman Abdelmawgoad Habib, Hazem Abosheaishaa, Mohammed A. Azab, Susannah Leaver, Arnaud Galbois, Bertrand Guidet, Cyril Charron, Emmanuel Guérot, Guillaume Besch, Jean‐Philippe Rigaud, Julien Maizel, Michel Djibré, Philippe Burtin, Pierre Garçon, Saad Nseir, Xavier Valette, Nica Alexandru, Nathalie Marin, Marie Vaissiere, Gaëtan Plantefève, Thierry Vanderlinden, Igor Jurcisin, Bruno Mégarbane, Anaïs Caillard, Arnaud Valent, Marc Garnier, Sébastien Besset, Johanna Oziel, Jean-Herlé Raphaelen, Stéphane Dauger, Guillaume Dumas, Bruno Gonçalves, Gaël Piton, Christian Jung, Raphael Romano Bruno, Malte Kelm, Georg Wolff, Eberhard Barth, Ulrich Goebel, Eberhard Barth, Anselm Kunstein, Michael Schuster, M. Welte, Matthias Lutz, Patrick Meybohm, Stephan Steiner, Tudor C. Poerner, Hendrik Haake
Abstract
BACKGROUND: health-related quality of life (HRQoL) is an important patient-centred outcome in patients surviving ICU admission for COVID-19. It is currently not clear which domains of the HRQoL are most affected. OBJECTIVE: to quantify HRQoL in order to identify areas of interventions. DESIGN: prospective observation study. SETTING: admissions to European ICUs between March 2020 and February 2021. SUBJECTS: patients aged 70 years or older admitted with COVID-19 disease. METHODS: collected determinants include SOFA-score, Clinical Frailty Scale (CFS), number and timing of ICU procedures and limitation of care, Katz Activities of Daily Living (ADL) dependence score. HRQoL was assessed at 3 months after ICU admission with the Euro-QoL-5D-5L questionnaire. An outcome of ≥4 on any of Euro-QoL-5D-5L domains was considered unfavourable. RESULTS: in total 3,140 patients from 14 European countries were included in this study. Three months after inclusion, 1,224 patients (39.0%) were alive and the EQ-5D-5L from was obtained. The CFS was associated with an increased odds ratio for an unfavourable HRQoL outcome after 3 months; OR 1.15 (95% confidence interval (CI): 0.71-1.87) for CFS 2 to OR 4.33 (95% CI: 1.57-11.9) for CFS ≧ 7. The Katz ADL was not statistically significantly associated with HRQoL after 3 months. CONCLUSIONS: in critically ill old intensive care patients suffering from COVID-19, the CFS is associated with the subjectively perceived quality of life. The CFS on admission can be used to inform patients and relatives on the risk of an unfavourable qualitative outcome if such patients survive.