Risk factors for impairments in quality of life and activities of daily living in survivors of critical illness: A systematic review of observational studies

Abstract

Introduction

The number of survivors of critical illnesses has increased over the years, resulting in impacts on quality of life and daily activities.

Objective

To investigate which intra-hospital risk factors are associated with worsening quality of life and functionality, through the assessment of basic and instrumental activities of daily living, in survivors of critical illness after hospital discharge.

Methods

Systematic literature review carried out from September 2022 to December 2023, informed by a flowchart, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search strategy carried out in the CINAHL, Embase and PubMed databases. The research was carried out by two researchers, without restrictions on language or year of publication. Studies were assessed using the Newcastle–Ottawa Quality Assessment Form for Cohort Studies.

Results

12 articles were included, 5 studies provided information on daily and instrumental activities, 7 on quality of life and 1 with all these outcomes. Risk factors such as depression, frailty, prolonged time on mechanical ventilation, and muscle weakness acquired in the ICU were considered factors associated with worsening quality of life. And depression, sepsis, prolonged stay in the ICU, and frailty are factors associated with worsening in the basic and instrumental activities of daily life.

Conclusion

Survivors of critical illness, in the first 3 months after discharge, present changes in quality of life, in basic and instrumental activities of daily living, which may persist for up to 12 months or more. This situation may be associated with risk factors at the time of admission to the intensive care unit.