Quality of life is about more than physical recovery after intensive care Pre-admission health counts more than the disease itself

Quality of life after an intensive care unit (ICU) admission is largely determined by how someone was doing beforehand. The medical condition and physical recovery play a smaller role. 'These findings allow us to start the conversation and provide care that better aligns with what matters to the patient and their family.'

An increasing number of patients survive an ICU admission. In the Netherlands, this applies to 88% of the 70,000 yearly admitted patients. Less attention is paid to the period afterwards. An ICU stay has a major impact on a person’s health, and recovery is often challenging. More than half of patients experience long-term problems, such as fatigue, muscle weakness or anxiety. This also greatly affects their families and loved ones.

Predictive models

At Radboud university medical center and Jeroen Bosch Hospital, Lucy Porter developed predictive models during her PhD research. The models estimate how someone will experience their quality of life one year after ICU admission. Porter explains: 'We followed over 4,000 patients from admission up to one year later, to gain insight into how they were doing before and after their ICU stay. Based on that data, we developed predictive models. These models show that pre-admission quality of life is a key factor.' Discussing expectations and predictions with patients and their families provides significant benefits, according to Porter. 'By making the expected changes in someone’s life after ICU admission a topic of conversation, depressive symptoms among family members were reduced.'

What defines quality of life?

Porter also studied what defines quality of life. It is not only shaped by physical fitness and medical factors, but also by personal and social circumstances. Porter: 'Quality of life is subjective. It is difficult to assess whether a certain situation will be acceptable for someone else. To what extent is quality of life determined by symptoms? Reading the newspaper every day in a comfortable chair may represent quality of life for one person, and a major limitation for another. Beyond physical and mental recovery, it involves intangible factors such as personal values, the ability to accept limitations, and support from one’s environment. All of these influence the perceived quality of life.'

Changing the conversation

The research results show that quality of life encompasses more than physical recovery after ICU admission. 'When predicting how someone will emerge from an ICU stay, we must focus on how they were doing before admission. That has a greater impact on quality of life afterwards than the course of the illness or physical condition. This insight can change the conversation we have, allowing us to provide care that better aligns with what is truly important to the patient and their family.'

More information about the dissertation

Phd defence: September 26, 2025 at 10:30 AM by Lucy Porter. Title of dissertation: Quality of life after critical illness (available online after 26 September). Supervisors: M. Van den Boogaard, H. Van der Hoeven, M. Zegers. Co-supervisor: K. Simons (Jeroen Bosch Hospital). The defense can be followed via this livestream.

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