Factors Influencing Quality of Life After Intensive Care: A Systematic Review and Meta-Analysis.

Abstract

The factors influencing quality of life (QOL) after intensive care are diverse and complex, and the QOL levels remain unclear. This systematic review and meta-analysis aimed to identify the factors influencing QOL and QOL levels in post-ICU patients. We searched eight databases: PubMed, Embase, EBSCOhost, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WeiPu, and WanFang, from inception to October 15, 2024. We included observational studies that examined factors influencing QOL in post-ICU patients. Two independent reviewers extracted and recorded the data. A total of 65 studies, encompassing 17,298 post-ICU patients, met the inclusion criteria. The key pre-ICU factors are advanced age (per 1-yr increase) (β: -0.045 [95% CI, -0.057 to -0.033]) and female gender (odds ratio: 1.104 (95% CI, 1.035-1.177]). The key intra-ICU factors are length of ICU stay (per 1-d increase) (β: -0.012 [95% CI, -0.019 to -0.005]), length of mechanical ventilation (per 1-d increase) (β: -0.005 [95% CI, -0.009 to -0.001]), and length of hospital stay (per 1-d increase) (β: -0.107 [95% CI, -0.161 to -0.054]). The pooled overall QOL score was 58.835 (95% CI, 52.935-64.735), the pooled physical component summary (PCS) score was 49.517 (95% CI, 45.781-53.253), the pooled mental component summary (MCS) score was 53.509 (95% CI, 50.301-56.718), and the pooled overall QOL index was 0.750 (95% CI, 0.713-0.787). Most pre-ICU and intra-ICU factors demonstrated strong associations with post-ICU QOL. The QOL in post-ICU patients remains at a moderate level, with the PCS score indicating greater impairment than the MCS score. Further research is highly recommended to explore effective intervention strategies to improve QOL in post-ICU patients, particularly concerning their physical well-being.