scholarly journals The Impact of Medical Conditions on the Quality of Life of Survivors at Discharge From Intensive Care Unit

Medicina ◽  
2011 ◽  
Vol 47 (5) ◽  
pp. 38 ◽  
Author(s):  
Andrius Klimašauskas ◽  
Ieva Sereikė ◽  
Aušra Klimašauskienė ◽  
Gintautas Kėkštas ◽  
Juozas Ivaškevičius
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ System ◽  
Therapeutic Interventions ◽  
Prolonged Stay ◽  
Role Physical ◽  
Icu Discharge ◽  
The Impact

Background and Objective. Impaired health-related quality of life (HRQOL) is one of the possible outcomes after discharge from an intensive care unit (ICU). Evaluation of patient health status on discharge from the ICU would help identify factors influencing changes in HRQOL after ICU discharge. The objective of the study was to identify whether health state on discharge from prolonged stay in the ICU has any influence on survivors’ HRQOL 6 months after intensive care. Material and Methods. A prospective study of patients with the prolonged length of stay (exceeding 7 days) in the ICU was conducted. The study covered the impact of organ system dysfunction (SOFA score), number of therapeutic interventions (TISS-28 score), and critical illness neuromuscular abnormalities (CINMA) on discharge from the ICU on HRQOL 6 months following ICU discharge. Results. In total, 137 patients were included in the study. The SOFA score on the last day in the ICU was 2.91 (SD, 1.57); the TISS-28 score on the last day in the ICU was 21.79 (SD, 4.53). Decreased physical functioning (PF) and role physical (RP) were identified. Circulatory impairment on discharge from the ICU had an impact on decreased PF (P=0.016), role physical (P=0.066), and role emotional (P=0.001). Patients with dysfunction in more than one organ system on ICU discharge had decreased role emotional (P=0.016). Severe CINMA was diagnosed in 18 patients. They had decreased PF (P=0.007) and RP (P=0.019). Patients with the TISS-28 score above or equal to 20 points showed lower HRQOL in the PF domain (P=0.077) and general health (P=0.038). Conclusions. HRQOL in patients with prolonged stay in the ICU is particularly impaired in the domains of physical functioning and role physical. It is associated with circulatory impairment, CINMA, and greater number of therapeutic interventions on discharge from the ICU.

Survival and Quality of Life of Patients with a Prolonged Stay in the Intensive Care Unit after Cardiac Surgeries – Remote Results

2019 ◽  
Author(s):  
Filip Abedinov ◽  
Neda Bakalova ◽  
Plamen Krastev ◽  
Iliyan Petrov ◽  
Ralitza Marinova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Prolonged Stay

scholarly journals Impact on Mental, Physical and Cognitive functioning of a Critical care sTay during the COVID-19 pandemic (IMPACCT COVID-19): protocol for a prospective, multicentre, mixed-methods cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053610
Author(s):  
Ana Cristina Castro-Ávila ◽  
Catalina Merino-Osorio ◽  
Felipe González-Seguel ◽  
Agustín Camus-Molina ◽  
Jaime Leppe
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Cognitive Functioning ◽  
Healthcare Professionals ◽  
Cognitive Impairments ◽  
Anxiety And Depression ◽  
Icu Discharge

IntroductionThe ongoing pandemic could affect the duration, variety and severity of the mental, physical, and cognitive impairments intensive care unit (ICU) survivors and their families frequently present. We aim to determine the impact of the COVID-19 pandemic on the mental, physical, and cognitive health of survivors, the experience of their families and their treating healthcare professionals.Methods and analysisProspective, multicentre, mixed-methods cohort study in seven Chilean ICUs. Sample: 450 adults, able to walk independently prior to admission, in ICU and mechanical ventilation >48 hours with and without COVID-19. Clinical Frailty Scale, Charlson comorbidity index, mobility (Functional Status Score for the Status Score for the Intensive Care Unit) and muscle strength (Medical Research Council Sum Score) will be assessed at ICU discharge. Cognitive functioning (Montreal Cognitive Assessment–blind), anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Impact of Event Scale-Revised) symptoms, disability (WHO Disability Assessment Schedule 2.0), quality of life (European Quality of Life Health Questionnaire), employment and survival will be assessed at ICU discharge, 3 months and 6 months. A sample will be assessed using actigraphy and the Global Physical Activity Questionnaire at 6 months after ICU discharge. Trajectories of mental, physical, and cognitive impairments will be estimated using multilevel longitudinal modelling. A sensitivity analysis using multiple imputations will be performed to account for missing data and loss-to-follow-up. Survival will be analysed using Kaplan-Meier curves. The perceptions of family members regarding the ICU stay and the later recovery will be explored 3 months after discharge. Healthcare professionals will be invited to discuss the challenges faced during the pandemic using semistructured interviews. Interviews will be thematically analysed by two independent coders to identify the main themes of the experience of family members and healthcare professionals.Ethics and disseminationThe study was approved by the Clinica Alemana Universidad del Desarrollo Ethics Committee (2020–78) and each participating site. Study findings will be published in peer-reviewed journals and disseminated through social media and conference meetings.Trial registration numberNCT04979897.

scholarly journals Intensive care units follow-up: a scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037725
Author(s):  
Danielle Prevedello ◽  
Marco Fiore ◽  
Jacques Creteur ◽  
J C Preiser
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
Scoping Review ◽  
Grey Literature ◽  
Icu Discharge ◽  
Scoping Reviews ◽  
The Impact

IntroductionIncreasing numbers of patients are surviving critical illness, leading to growing concern about the potential impact of the long-term consequences of intensive care on patients, families and society as a whole. These long-term effects are together known as postintensive care syndrome and their presence can be evaluated at intensive care unit (ICU) follow-up consultations. However, the services provided by these consultations vary across hospitals and units, in part because there is no validated standard model to evaluate patients and their quality of life after ICU discharge. We describe a protocol for a scoping review focusing on models of ICU follow-up and the impact of such strategies on improving patient quality of life.Methods and analysisIn this scoping review, we will search the literature systematically using electronic databases (MEDLINE - from database inception to June 15th 2020) and a grey literature search. We will involve stakeholders as recommended by the Joanna Briggs Institute approach developed by Peters et al. The research will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines.Ethics and disseminationThis study does not require ethics approval, because data will be obtained through a review of published primary studies. The results of our evaluation will be published in a peer-reviewed journal and will also be disseminated through presentations at national and international conferences.

scholarly journals Design and conduct of a multicenter randomized clinical trial on the impact of a post-intensive care unit multidisciplinary follow-up on the quality of life (suivi-rea) (Preprint)

2021 ◽  
Author(s):  
Friedman Diane ◽  
Lamiae Grimaldi ◽  
Alain Cariou ◽  
Philippe Aegerter ◽  
Stéphane Gaudry ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
Controlled Trial ◽  
Social Evaluation ◽  
Double Blind ◽  
Icu Discharge ◽  
One Year ◽  
The Impact

UNSTRUCTURED Introduction: Critically ill patients are at risk to develop a Post-Intensive Care Syndrome (PICS), which is characterized by physical, psychological and cognitive impairments and dramatically impacts the quality of life. No intervention has been shown to improve the quality of life (QoL). Because of the interdependency of its domains, we hypothesized that a medical, psychological and social follow-up would improve the QoL by mitigating the PICS. Methods and analysis: We conducted a multicenter, double-blind, randomized controlled trial comparing a multidisciplinary to a standard post-ICU follow-up. In the intervention arm, multidisciplinary follow-up consisted of medical, psychological and social evaluation at ICU discharge and at 3, 6 and 12 months after ICU discharge. In the placebo group, patients were seen only at 12 months by the multidisciplinary team. The baseline characteristics at ICU discharge were collected in all patients. The primary outcome was the quality of life at one year, assessed with help of EuroQoL 5 dimensions (EQ5D). Secondary outcomes were mortality, cognitive, psychological and functional status, the social and professional reintegration as well as the rate of re-hospitalization and outpatient consultations at one year. The first patient was randomized on 20/12/2012 and the last patient on 01/09/2017 out of 546 patients who were enrolled across 11 ICUs. At present, data management is still ongoing, and all parties involved in the trial remain blinded. Ethics and dissemination – Research Ethics Committee of Saint-Germain-en-Laye, France, initial approval received on 08/07/2011. Results will be disseminated via peer-reviewed publication and presentation at international conferences. Trial registration: Clinicaltrials.gov identifier NCT01796509 (registered on 21/02/2013).

scholarly journals Long-term Quality of Life After Intensive Care Unit Admission (a Single-Center Observational Study)

2021 ◽  
Vol 17 (2) ◽  
pp. 72-87
Author(s):  
C. Leggieri ◽  
L. Dezza ◽  
B. Oltolini ◽  
R. Lembo ◽  
B. Noto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Short Form ◽  
University Hospital ◽  
Synthetic Index ◽  
Sf 36 ◽  
Icu Discharge

Patients may experience long-term physical, psychological and cognitive impairment after intensive care unit (ICU) discharge, a condition commonly described as post-intensive care syndrome. The relative contribution of each of these components to long-term quality of life was never investigated.The aim of this studyis to identify the type and severity of disability and QoL at the discharge from ICU and up to following 6 months.Material and Methods. All patients (n=218) discharged from a university hospital ICU between April 2016 and July 2017 were eligible. Exclusion criteria included: age <18 years, brain or spinal injury, life expectancy <90 days, and ICU stay <12 hours. The Short Form Health Survey (SF-36), and 5-level EuroQoL-5D (EQ-5D-5L) questionnaires were administered at ICU discharge, and at 30-, 90- and 180-days. We compared patients requiring short-term ICU monitoring (IM, Intensive Monitoring,n=109) or patients requiring ICU treatment (IT, Intensive Treatment,n=109).Results. All dimensions of SF-36 and EQ-5D-5L parameters increased from ICU discharge to 180-days, except for the SF-36 Synthetic index linked to mental health (P=0.08). All EQ-5D-5L parameters improved significantly in the IT group, while only Visual Analog Scale Health Perception improved in the IM group.Conclusion. ICU survivors suffer long-term physical and psychological sequelae. The perception of Quality of Life is reduced after ICU discharge. The psychological and cognitive dimensions were more compromised than physical ones. Patients discharged from the ICU may benefit from specific intensive care follow-up clinics addressing their needs in term of psychological and cognitive support.

scholarly journals The impact of intensive care unit diaries on patients’ and relatives’ outcomes: a systematic review and meta-analysis

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Bruna Brandao Barreto ◽  
Mariana Luz ◽  
Marcos Nogueira de Oliveira Rios ◽  
Antonio Alberto Lopes ◽  
Dimitri Gusmao-Flores
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Psychiatric Disorders ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
The Impact ◽  
Icu Diary

Abstract Background Memory gaps in intensive care unit (ICU) survivors are associated with psychiatric disorders. The ICU diaries improve the patient’s factual memory of the ICU, but it is not clear if they reduce the incidence of psychiatric disorders in patients and relatives after hospital discharge. The aim of this study is to evaluate the literature on the effect of ICU diaries for patients admitted in ICU and their relatives. Methods Two authors independently searched the online databases PubMed, OVID, Embase, EBSCO host, and PsycINFO from inception to July 2019. Studies were included if the intervention group (ICU diary) was compared with a group with no diaries and the sample was comprised patients ≥ 18 years old admitted in the ICU for more than 24 h and their relatives. Randomized clinical trials, observational studies, letter with original data, and abstracts were included, irrespective of the language. The search was not limited by any specific outcome. Review articles, commentaries, editorials, and studies without a control group were excluded. Structured tools were used to assess the methodological quality (“Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I)” for cohort studies and the “Cochrane Risk of Bias tool” for included RCTs and before/after studies). A random-effects model was employed considering the anticipated variability between the studies. Results Seven hundred eighty-five titles were identified for screening. Two additional studies were selected after a reference search, and after a full-text review, a total of 12 studies were included. When pooling the results, ICU diary was associated with lower risk of depression (RR 0.41, 95% CI 0.23–0.75) and better quality of life (10.3 points higher in SF-36 general health score, 95% CI 0.79–19.8), without a decrease in anxiety or post-traumatic stress disorder (PTSD). For the relatives receiving an ICU diary, there was no difference in the incidence of PTSD, anxiety, or depression. Conclusion and relevance This systematic review and meta-analysis supports the use of ICU diaries to reduce the risk of depression and preserve the quality of life of patients after ICU admission. ICU diaries do not seem to have any beneficial effect on the relatives of the patients. Trial registration PROSPERO, CRD42019136639

scholarly journals Families' perception, knowledge, and psychological stressors associated with transition of care from the intensive care unit

2019 ◽  
Vol 2 (1) ◽  
pp. 53-56
Author(s):  
Gustavo Ferrer ◽  
Chi Chan Lee ◽  
Monica Egozcue ◽  
Hector Vazquez ◽  
Melissa Elizee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Family Members ◽  
Expected Improvement ◽  
Transition Of Care ◽  
Care Providers ◽  
Icu Discharge ◽  
Family Perceptions

Background: During the process of transition of care from the intensive care setting, clarity, and understanding are vital to a patient's outcome. A successful transition of care requires collaboration between health-care providers and the patient's family. The objective of this project was to assess the quality of continuity of care with regard to family perceptions, education provided, and psychological stress during the process. Methods: A prospective study conducted in a long-term acute care (LTAC) facility. On admission, family members of individuals admitted to the LTAC were asked to fill out a 15-item questionnaire with regard to their experiences from preceding intensive care unit (ICU) hospitalization. The setting was an LTAC facility. Patients were admitted to an LTAC after ICU admission. Results: Seventy-six participants completed the questionnaire: 38% expected a complete recovery, 61% expected improvement with disabilities, and 1.3% expected no recovery. With regard to the length of stay in the LTAC, 11% expected < 1 week, 26% expected 1 to 2 weeks, 21% expected 3 to 4 weeks, and 42% were not sure. Before ICU discharge, 33% of the participants expected the transfer to the LTAC. Also, 72% did not report a satisfactory level of knowledge regarding their family's clinical condition or medical services required; 21% did not receive help from family members; and 50% reported anxiety, 20% reported depression, and 29% reported insomnia. Conclusion: Families' perception of patients' prognosis and disposition can be different from what was communicated by the physician. Families' anxiety and emotional stress may precipitate this discrepancy. The establishment of optimal projects to eliminate communication barriers and educate family members will undoubtedly improve the quality of transition of care from the ICU.

Quality of life during the first 6 months of interferon-b treatment in patients with MS

2000 ◽  
Vol 6 (5) ◽  
pp. 338-342
Author(s):  
J HA Arnoldus ◽  
J Killestein ◽  
L EMA Pfennings ◽  
B Jelles ◽  
B MJ Uitdehaag ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Side Effects ◽  
Physical Functioning ◽  
Bodily Pain ◽  
Significant Linear Trend ◽  
Role Physical ◽  
Sf 36 ◽  
The Impact

Objectives: To determine the quality of life (QoL) of MS patients during the initial 6 months of treatment with interferon-b (IFN-b). Furthermore, to determine whether changes in QoL relate to disability, emotional state, therapeutic expectations or side effect profile. Background: IFN-b has been shown to have beneficial effects on the course of MS. Since the aim of IFN-b treatment is not to cure but to slow down the disease it is important to know how this treatment affects QoL. Surprisingly, the impact of treatment with IFN-b on QoL measures has not been extensively studied so far. Methods: Case report documentation, including EDSS, SF-36 and MADRAS scores, of 51 relapsing-remitting MS patients treated with IFN-b was obtained at baseline and at months 1, 3 and 6. Patients also filled in a form about their expectations of therapy and a questionnaire on side effects. Results: During treatment there was a significant linear trend indicating improvement in the role-physical functioning (RPF) scale of the SF-36 (F1,50=4.9, P=0.032). A transient decrease at month 1 was found in the scale for bodily pain, indicating more experienced pain (F1,50=19.8, P50.001). Subgroup analysis showed that patients with most depressive symptoms on the MADRAS at baseline contributed most to the increase in RPF scores over time (F1,24=5,6 P=0.026). Furthermore, we found associations between adverse event scores and several domains of QoL. Conclusions: Our findings suggest that IFN-b therapy has an impact on QoL of MS patients in that it improves role-physical functioning and transiently worsens experienced bodily pain. QoL during treatment with IFN-b is influenced by depressive symptoms at baseline as well as by treatment-associated side-effects.

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