Long-term outcomes after critical illness: recent insights

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Abstract

Intensive care survivors often experience post-intensive care sequelae, which are frequently gathered together under the term “post-intensive care syndrome” (PICS). The consequences of PICS on quality of life, health-related costs and hospital readmissions are real public health problems. In the present Viewpoint, we summarize current knowledge and gaps in our understanding of PICS and approaches to management.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13054-021-03535-3.

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Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference.

Dale M Needham, Judy R. Davidson, Henry Cohen … (2012)

Millions of patients are discharged from intensive care units annually. These intensive care survivors and their families frequently report a wide range of impairments in their health status which may last for months and years after hospital discharge. To report on a 2-day Society of Critical Care Medicine conference aimed at improving the long-term outcomes after critical illness for patients and their families. Thirty-one invited stakeholders participated in the conference. Stakeholders represented key professional organizations and groups, predominantly from North America, which are involved in the care of intensive care survivors after hospital discharge. Invited experts and Society of Critical Care Medicine members presented a summary of existing data regarding the potential long-term physical, cognitive and mental health problems after intensive care and the results from studies of postintensive care unit interventions to address these problems. Stakeholders provided reactions, perspectives, concerns and strategies aimed at improving care and mitigating these long-term health problems. Three major themes emerged from the conference regarding: (1) raising awareness and education, (2) understanding and addressing barriers to practice, and (3) identifying research gaps and resources. Postintensive care syndrome was agreed upon as the recommended term to describe new or worsening problems in physical, cognitive, or mental health status arising after a critical illness and persisting beyond acute care hospitalization. The term could be applied to either a survivor or family member. Improving care for intensive care survivors and their families requires collaboration between practitioners and researchers in both the inpatient and outpatient settings. Strategies were developed to address the major themes arising from the conference to improve outcomes for survivors and families.

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Developing core outcome sets for clinical trials: issues to consider

Paula Williamson, Douglas G. Altman, Jane Blazeby … (2012)

The selection of appropriate outcomes or domains is crucial when designing clinical trials in order to compare directly the effects of different interventions in ways that minimize bias. If the findings are to influence policy and practice then the chosen outcomes need to be relevant and important to key stakeholders including patients and the public, health care professionals and others making decisions about health care. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials. These issues could be addressed through the development and use of an agreed standardized collection of outcomes, known as a core outcome set, which should be measured and reported, as a minimum, in all trials for a specific clinical area. Accumulating work in this area has identified the need for general guidance on the development of core outcome sets. Key issues to consider in the development of a core outcome set include its scope, the stakeholder groups to involve, choice of consensus method and the achievement of a consensus.

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Post-hospital syndrome--an acquired, transient condition of generalized risk.

Harlan M. Krumholz (2013)

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Author and article information

Contributors

Jean-Charles Preiser:

ORCID: http://orcid.org/0000-0003-3163-0390

Jean-Charles.Preiser@erasme.ulb.ac.be

Journal

Journal ID (nlm-ta): Crit Care

Title: Critical Care

Publisher: BioMed Central (London )

ISSN (Print): 1364-8535

ISSN (Electronic): 1466-609X

Publication date (Electronic): 17 March 2021

Publication date PMC-release: 17 March 2021

Publication date Collection: 2021

Volume: 25

Electronic Location Identifier: 108

Affiliations

[1 ]GRID grid.4861.b, ISNI 0000 0001 0805 7253, Department of Intensive Care and Burn Center, University Hospital, , University of Liège, ; Liège, Belgium

[2 ]GRID grid.214458.e, ISNI 0000000086837370, Department of Internal Medicine, , University of Michigan, ; Ann Arbor, MI USA

[3 ]GRID grid.417895.6, ISNI 0000 0001 0693 2181, Department of Critical Care, , Imperial College Healthcare NHS Trust, ; London, UK

[4 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, Department of Surgery and Cancer, , Imperial College London, ; London, UK

[5 ]GRID grid.6363.0, ISNI 0000 0001 2218 4662, Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), , Charité – Universitätsmedizin Berlin, ; Berlin, Germany

[6 ]GRID grid.14095.39, ISNI 0000 0000 9116 4836, Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health, ; Berlin, Germany

[7 ]GRID grid.413328.f, ISNI 0000 0001 2300 6614, Réanimation Médicale, , Hôpital St Louis, ; Paris, France

[8 ]GRID grid.4989.c, ISNI 0000 0001 2348 0746, Department of Intensive Care, Erasme University Hospital, , Université Libre de Bruxelles, ; Brussels, Belgium

[9 ]GRID grid.412725.7, Department of Anesthesiology, Critical Care and Emergency, , Spedali Civili University Hospital, ; Brescia, Italy

[10 ]GRID grid.7637.5, ISNI 0000000417571846, Department of Surgical Specialties, Radiological Sciences and Public Health, , University of Brescia, ; Brescia, Italy

[11 ]GRID grid.5288.7, ISNI 0000 0000 9758 5690, Division of Pulmonary and Critical Care Medicine, , Oregon Health and Science University, ; Portland, OR USA

[12 ]GRID grid.412157.4, ISNI 0000 0000 8571 829X, Erasme University Hospital, ; Route de Lennik 808, Brussels, Belgium

Author information

Jean-Charles Preiser http://orcid.org/0000-0003-3163-0390

Article

Publisher ID: 3535

DOI: 10.1186/s13054-021-03535-3

PMC ID: 7968190

PubMed ID: 33731201

SO-VID: c5dba35e-57bb-4514-b906-195423b02747

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 22 December 2020

Date accepted : 5 March 2021

Custom metadata

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: intensive care unit,post-intensive care syndrome,critically ill,core set,quality of care,icu-acquired weakness,muscle weakness,post-traumatic stress disorder,follow-up

Data availability:

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: intensive care unit, post-intensive care syndrome, critically ill, core set, quality of care, icu-acquired weakness, muscle weakness, post-traumatic stress disorder, follow-up

Long-term outcomes after critical illness: recent insights

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Abstract

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Preventive and Emergency Medicine Insights

Most cited references 50

Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference.

Developing core outcome sets for clinical trials: issues to consider

Post-hospital syndrome--an acquired, transient condition of generalized risk.

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