A Feasibility Study of Functional Status and Follow-Up Clinic Preferences of Patients at High Risk of Post Intensive Care Syndrome. Issue 3 (May 2016)

• Record Type: Journal Article
• Authors: Farley, K. J.; Eastwood, G. M.; Bellomo, R.
• Is Part Of: Anaesthesia and intensive care. Volume 44:Issue 3(2016)
• Page Start: 413
• Page End: 419
• Publication Date: 2016-05
• Subjects: intensive care -- prolonged ICU stay -- post intensive care syndrome -- ICU follow-up clinic -- critical illness -- rehabilitation; Anesthesiology -- Periodicals; Intensive Care Units -- Periodicals; 617.96
• DOI: 10.1177/0310057X1604400310
• Languages: English
• ISSNs: 0310-057X

Abstract

After prolonged mechanical ventilation patients may experience the 'post intensive care syndrome' (PICS) and may be candidates for post-discharge follow-up clinics. We aimed to ascertain the incidence and severity of PICS symptoms in patients surviving prolonged mechanical ventilation and to describe their views regarding follow-up clinics. In a teaching hospital, we conducted a cohort study of all adult patients discharged alive after ventilation in ICU for ≥7 days during 2013. We administered the EuroQol-5D (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) via telephone interview and asked patients their views about the possible utility of a follow-up clinic. We studied 48 patients. At follow-up (average 19.5 months), seven (15%) patients had died and 14 (29%) did not participate (eight declined; two were non–English speakers; four were non-contactable). Among the 27 responders, 16 (59%) reported at least moderate problems in ≥1 EQ-5D dimension; 10 (37%) in ≥2 dimensions, and 8 (30%) in ≥3 dimensions. Moreover, 10 (37%) patients reported marked psychological symptoms; six (22%) scored borderline or abnormal on the HADS for both anxiety and depression; and four (15%) scored borderline or abnormal for one component. Finally, 21/26 (81%) patients stated that an ICU follow-up clinic would have been beneficial. At long–term follow-up, the majority of survivors of prolonged mechanical ventilation reported impaired quality of life and significant psychological symptoms. Most believed that a follow-up clinic would have been beneficial.