Dichotomous good outcome indicates mobility more than cognitive or social quality of life

Andrew M. Naidech, Jennifer L. Beaumont, Michael Berman, Brandon Francis, Eric Liotta, Matthew B. Maas, Shyam Prabhakaran, Jane Holl, David Cella

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Design: We defined good outcome as 0 through 3 (independent ambulation or better) versus 4 through 5 (dependent) on the modified Rankin Scale at 1, 3, and 12 months. We simultaneously assessed the modified Rankin Scale and health-related quality of life using web-based computer adaptive testing in the domains of mobility, cognitive function (executive function and general concerns), and satisfaction with social roles and activities. We compared the area under the curve between different health-related quality of life domains. Setting: Neurologic ICU with web-based follow-up. Patients: One hundred fourteen patients with subarachnoid hemorrhage or intracerebral hemorrhage. Interventions: None. Measurement and Main Results: We longitudinally followed 114 survivors with data at 1 month, 62 patients at 3 months, and 58 patients at 12 months. At 1 month, area under the curve was highest for mobility (0.957; 95% CI, 0.904-0.98), higher than cognitive function-general concerns (0.819; 95% CI, 0.715-0.888; p = 0.003 compared with mobility), satisfaction with social roles and activities (0.85; 95% CI, 0.753-0.911; p = 0.01 compared with mobility), and cognitive function-executive function (0.879; 95% CI, 0.782-0.935; p = 0.058 compared with mobility). Optimal specificity and sensitivity for receiver operating characteristic analysis were approximately 1.5 sd below the U.S. population mean. Conclusions: Health-related quality of life assessments reliably distinguished between good and poor outcomes as determined by the modified Rankin Scale. Good outcome indicated healthrelated quality of life about 1.5 sd below the U.S. population mean. Associations were weaker for cognitive function and social function than mobility.

Original languageEnglish (US)
Pages (from-to)1654-1659
Number of pages6
JournalCritical care medicine
Volume43
Issue number8
DOIs
StatePublished - Jan 1 2015

Keywords

  • Critical care
  • Internet
  • Intracerebral hemorrhage
  • Outcomes assessment
  • Quality of life
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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