Long term follow-up of functional outcome and quality of life after admission of obstetric patients to the ICU: A controlled cross-sectional study with interviews.

INTRODUCTION

The rate of intensive care unit (ICU) admission of obstetric patients in high-income countries is approximately 0.4%. ICU admission can negatively affect quality of life (QoL).

AIM: To assess survival status of obstetric patients admitted to ICU. Secondary outcomes included domiciliary status and QoL versus matched controls without ICU admission.

METHODS

Bi-center, cross-sectional questionnaire study of patients admitted to an ICU and controls of non-ICU patients, matched for date of admission, demographics, obstetric history and neonatal outcome. Survival was determined via the Central National Population Registry. QoL and postpartum depression (PPD) were assessed at hospital discharge and at time of interview. Post-Traumatic Stress Disorder (PTSD) was assessed up to the time of interview.

RESULTS

Among 216 ICU admission, seven died (3.2%). Overall, 128 patients were interviewed (64 ICU patients vs. 64 non-ICU patients). All participants were living at home. ICU survivors had lower QoL at the time of hospital discharge (42.6 ± 22.4 vs. 60.2 ± 18.9, p < 0.001) compared to non-ICU controls, but by the time of interview QoL was similar between cohorts. ICU survivors also had higher rates of PPD at hospital discharge (51.6% vs. 17.2%, p < 0.001) and at interview (12.5% vs. 0%, p = 0.003) and higher rates of PTSD versus controls (10.9% vs. 1.6%, p = 0.030).

CONCLUSION

In this study, one in thirty ICU obstetric patients died. Critical illness with ICU admission carried short- and long-term implications in terms of QoL and psychological morbidity. Most patients reported improvement over time, but this process spanned months to years.