Factors affecting health-related quality of life in ICU survivors

Abstract

This multicenter prospective study investigated factors influencing mid-term health-related quality of life (HRQoL) among intensive care unit (ICU) survivors in Korea. Among 2,002 patients, 189 who completed follow-up assessments at 90 days post-discharge were included in the final analysis. HRQoL was measured using the five-level EuroQoL 5-Dimension (EQ-5D-5L) and Hospital Anxiety and Depression Scale (HADS) at 30 and 90 days after discharge. Multivariable regression identified older age, infection as the cause of ICU admission, higher clinical frailty scale (CFS), and baseline HADS scores as independent predictors of lower EQ-5D-5L scores at 90 days. Initial HADS and CFS were also significantly associated with persistent anxiety and depression symptoms. Specific domains of HRQoL, such as mobility, self-care, and usual activity, were particularly affected by these factors. The findings underscore the importance of early psychological and frailty assessments in ICU patients, as these measures can help identify individuals at risk for poor recovery trajectories. Routine evaluation and targeted interventions for patients with high anxiety, depression, or frailty at ICU admission may improve long-term outcomes and overall quality of life after critical illness.