Physical, Mental, and Cognitive Health Status of ICU Survivors Before ICU Admission: A Cohort Study.
Crit Care Med
; 48(9): 1271-1279, 2020 09.
Article
em En
| MEDLINE
| ID: mdl-32568858
ABSTRACT
OBJECTIVES:
Although patient's health status before ICU admission is the most important predictor for long-term outcomes, it is often not taken into account, potentially overestimating the attributable effects of critical illness. Studies that did assess the pre-ICU health status often included specific patient groups or assessed one specific health domain. Our aim was to explore patient's physical, mental, and cognitive functioning, as well as their quality of life before ICU admission.DESIGN:
Baseline data were used from the longitudinal prospective MONITOR-IC cohort study.SETTING:
ICUs of four Dutch hospitals. PATIENTS Adult ICU survivors (n = 2,467) admitted between July 2016 and December 2018.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
Patients, or their proxy, rated their level of frailty (Clinical Frailty Scale), fatigue (Checklist Individual Strength-8), anxiety and depression (Hospital Anxiety and Depression Scale), cognitive functioning (Cognitive Failure Questionnaire-14), and quality of life (Short Form-36) before ICU admission. Unplanned patients rated their pre-ICU health status retrospectively after ICU admission. Before ICU admission, 13% of all patients was frail, 65% suffered from fatigue, 28% and 26% from symptoms of anxiety and depression, respectively, and 6% from cognitive problems. Unplanned patients were significantly more frail and depressed. Patients with a poor pre-ICU health status were more often likely to be female, older, lower educated, divorced or widowed, living in a healthcare facility, and suffering from a chronic condition.CONCLUSIONS:
In an era with increasing attention for health problems after ICU admission, the results of this study indicate that a part of the ICU survivors already experience serious impairments in their physical, mental, and cognitive functioning before ICU admission. Substantial differences were seen between patient subgroups. These findings underline the importance of accounting for pre-ICU health status when studying long-term outcomes.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Nível de Saúde
/
Saúde Mental
/
Disfunção Cognitiva
/
Unidades de Terapia Intensiva
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
/
Patient_preference
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Crit Care Med
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Holanda