Summary
The impact of critical illness: the long-term physical, mental and cognitive health problems in ICU survivors
AIM: To gain insight into the new experienced physical, mental and cognitive problems and quality of life 1-year after ICU admission, and into interventions to prevent or mitigate these long-term problems.
METHOD: Prospective multicenter cohort study in which patients or proxies rated their health status before and 1-year after ICU admission. Systematic review and meta-analyses to assess effectiveness of interventions.
FINDINGS: Of the 2,345 patients, new physical, mental and cognitive problems were experienced by 40% of the elective surgical and 60% of the medical and urgent surgical patients. In all three groups, a significant increase in cognitive problems was seen. Pre-ICU health status was strongly associated with the long-term post-ICU problems. There was scarce evidence that the use of ICU-diaries and exercise programs were effective to prevent or mitigate these long-term problems. Other commonly used interventions were not yet found to be effective.
DISCUSSION AND CONCLUSION: Many ICU patients experienced long-term health problems impacting their daily life and negatively affecting their quality of life. Minimizing risk factors before, during and after ICU stay is necessary to prevent or mitigate these long-term problems. It is pivotal to inform patients and their relatives about the impact of long-term problems they might experience.
Keywords: critical care; critical illness; outcome assessment; patient-reported outcome measures; quality of life
