Longitudinal trajectories of health-related quality of life among critical care survivors: A latent class growth approach

OBJECTIVES: This study explored the trajectories of health-related quality of life (HRQOL) and the factors influencing these trajectories. RESEARCH METHODOLOGY/DESIGN: Prospective observational cohort study. SETTING: 19 intensive care units (ICUs) in South Korea. MAIN OUTCOME MEASURES: We used the Medical Outcomes Study Short Form version 2 (SF-36v2) to assess HRQOL at 3, 6, 12, and 24 months post-discharge. Additionally, we evaluated intensive care experience, post-intensive care syndrome, and demographic and clinical characteristics to identify factors. HRQOL trajectory groups were identified via latent class growth modeling, with determining factors analyzed using multinomial logistic regression. RESULTS: The analysis identified three distinct groups for the physical component summary (PCS) and mental component summary (MCS) of the SF-36v2. For the PCS, the groups were labeled "Resilient Stable," "Moderate Recovered," and "Slow Recovering." For the MCS, the classifications were "Resilient Stable," "Low Recovered," and "Persistent Low." The determinants of the PCS Moderate Recovered and Slow Recovering Groups included older age, female gender, less educated, increased comorbidities, discharge to extended care facilities, and post-intensive care syndrome. Conversely, the MCS Low Recovered and Persistent Low Groups were determined by the intensive care experience and post-intensive care syndrome. CONCLUSION: Our study identified specific vulnerable groups for PCS and MCS and their determinants in terms of HRQOL recovery among ICU survivors. IMPLICATIONS FOR CLINICAL PRACTICE: There is a need for a preemptive approach for survivors with determinants that place them in vulnerable groups for poorer HRQOL as well as systematic monitoring of post-intensive care syndrome in various healthcare settings.