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Vocal function following discharge from intensive care

Published online by Cambridge University Press:  11 January 2010

I Nixon*
Affiliation:
Department of ENT, North Glasgow Hospitals NHS Trust, Gartnavel General Hospital, Scotland, UK
S Ramsay
Affiliation:
Department of Anaesthesia, North Glasgow Hospitals University Division, Scotland, UK
K MacKenzie
Affiliation:
Department of ENT, North Glasgow Hospitals University Division, Scotland, UK
*
Address for correspondence: Mr Iain Nixon, Department of ENT, North Glasgow Hospitals NHS Trust, Gartnavel General Hospital, Great Western Road, Glasgow G12 0YN, Scotland, UK. E-mail: [email protected]

Abstract

Introduction:

There is growing interest in the long term outcomes of critical care. The degree of vocal morbidity suffered by patients surviving intensive care admission has not previously been reported.

Objective:

To determine the degree of subjective, patient-reported vocal morbidity following discharge from intensive care.

Materials and methods:

A prospective study was undertaken of patients admitted to intensive care. A total of 273 consecutive admissions were assessed; 181 patients were suitable for inclusion.

Main outcome measure:

The Voice Symptom Scale questionnaire.

Results:

Eighty-three patients responded. Twenty-seven patients (33 per cent) reported a degree of vocal morbidity greater than that suffered by patients treated for early laryngeal cancer. Thirteen patients (16 per cent) reported a degree of morbidity greater than that suffered by patients attending voice clinics.

Conclusion:

Up to one-third of patients who survived admission to an intensive care unit reported suffering significant vocal morbidity. The Voice Symptom Scale could be used in an intensive care follow-up setting to identify and ensure the referral of such patients.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

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Footnotes

Presented at the Laryngology Section, Royal Society of Medicine, 5 September 2008, London, UK (poster); The Intensive Care Society State of the Art Meeting, 18 December 2007, London, UK (poster); the Scottish Otolaryngological Society Summer Meeting, 10 May 2007, Dunkeld, UK; and the Oto-Rhino-Laryngological Research Society Meeting, 30 March 2007, Glasgow, UK.

References

1Griffiths, RD, Jones, C. Seven lessons from 20 years of follow-up of intensive care unit survivors. Curr Opin Crit Care 2007;13:508–13CrossRefGoogle ScholarPubMed
2Rattray, J, Crocker, C. The intensive care follow-up clinic: current provision and future direction? Nurs Crit Care 2007;12:13CrossRefGoogle ScholarPubMed
3Griffiths, JA, Barber, VS, Cuthbertson, BH, Young, JD. A national survey of intensive care follow-up clinics. Anaesthesia 2006;61:950–5CrossRefGoogle ScholarPubMed
4Department of Health. Comprehensive Critical Care – a Review of Adult Critical Care Services. Crown Copyright, London, 2000Google Scholar
5Department of Health. Comprehensive Critical Care – a Review of Adult Critical Care Services. Crown Copyright, London, 2003Google Scholar
6Cuthbertson, BH, Rattray, J, Johnston, M, Wildsmith, JA, Wilson, E, Hernendez, R et al. A pragmatic randomised, controlled trial of intensive care follow up programmes in improving longer-term outcomes from critical illness. The PRACTICAL study. BMC Health Serv Res 2007;7:116CrossRefGoogle ScholarPubMed
7Kastanos, N, Estopa Miro, R, Marin Perez, A, Xaubet Mir, A, Agusti-Vidal, A. Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study. Crit Care Med 1983;11:362–7CrossRefGoogle ScholarPubMed
8Colice, GL, Stukel, TA, Dain, B. Laryngeal complications of prolonged intubation. Chest 1989;96:877–84CrossRefGoogle ScholarPubMed
9Steele, AP, Evans, HW, Afaq, MA, Robson, JM, Dourado, J, Tayar, R et al. Long-term follow-up of Griggs percutaneous tracheostomy with spiral CT and questionnaire. Chest 2000;117:1430–3CrossRefGoogle ScholarPubMed
10Oguz, H, Tarhan, E, Korkmaz, M, Yilmaz, U, Safak, MA, Demirci, M et al. Acoustic analysis findings in objective laryngopharyngeal reflux patients. J Voice 2007;21:203–10CrossRefGoogle ScholarPubMed
11Leonard, RC, Lewis, RH, Singh, B, van Heerden, PV. Late outcome from percutaneous tracheostomy using the Portex kit. Chest 1999;115:1070–5CrossRefGoogle ScholarPubMed
12Sviri, S, Samie, R, Roberts, BL, van Heerden, PV. Long-term outcomes following percutaneous tracheostomy using the Griggs technique. Anaesth Intensive Care 2003;31:401–7CrossRefGoogle ScholarPubMed
13Mittendorf, EA, McHenry, CR, Smith, CM, Yowler, CJ, Peerless, JR. Early and late outcome of bedside percutaneous tracheostomy in the intensive care unit. Am Surg 2002;68:342–6CrossRefGoogle ScholarPubMed
14Jones, SM, Carding, PN, Drinnan, MJ. Exploring the relationship between severity of dysphonia and voice-related quality of life. Clin Otolaryngol 2006;31:411–17CrossRefGoogle ScholarPubMed
15Deary, IJ, Wilson, JA, Carding, PN, MacKenzie, K. VoiSS: a patient-derived Voice Symptom Scale. J Psychosom Res 2003;54:483–9CrossRefGoogle ScholarPubMed
16Wilson, JA, Webb, A, Carding, PN, Steen, IN, MacKenzie, K, Deary, IJ. The Voice Symptom Scale (VoiSS) and the Vocal Handicap Index (VHI): a comparison of structure and content. Clin Otolaryngol Allied Sci 2004;29:169–74CrossRefGoogle ScholarPubMed
17Knaus, WA, Zimmerman, JE, Wagner, DP, Draper, EA, Lawrence, DE. APACHE-acute physiology and chronic health evaluation: a physiologically based classification system. Crit Care Med 1981;9:591–7CrossRefGoogle ScholarPubMed
18Publishing BPGaR. British National Formulary September 2007. London: RPS Publishing, 2007Google Scholar
19Loughran, S, Calder, N, MacGregor, FB, Carding, P, MacKenzie, K. Quality of life and voice following endoscopic resection or radiotherapy for early glottic cancer. Clin Otolaryngol 2005;30:42–7CrossRefGoogle ScholarPubMed
20Schelling, G, Stoll, C, Haller, M, Briegel, J, Manert, W, Hummel, T et al. Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome. Crit Care Med 1998;26:651–9CrossRefGoogle ScholarPubMed
21Graf, J, Wagner, J, Graf, C, Koch, KC, Janssens, U. Five-year survival, quality of life, and individual costs of 303 consecutive medical intensive care patients – a cost-utility analysis. Crit Care Med 2005;33:547–55CrossRefGoogle ScholarPubMed
22Niskanen, M, Ruokonen, E, Takala, J, Rissanen, P, Kari, A. Quality of life after prolonged intensive care. Crit Care Med 1999;27:1132–9CrossRefGoogle ScholarPubMed
23Orwelius, L, Nordlund, A, Edell-Gustafsson, U, Simonsson, E, Nordlund, P, Kristenson, M et al. Role of preexisting disease in patients' perceptions of health-related quality of life after intensive care. Crit Care Med 2005;33:1557–64CrossRefGoogle ScholarPubMed
24Rubenfeld, GD. Interventions to improve long-term outcomes after critical illness. Curr Opin Crit Care 2007;13:476–81CrossRefGoogle ScholarPubMed