Post-intensive care unit (ICU) sequelae, including physical and mental health problems, are relatively unexplored. Characteristics commonly used to predict outcome lack prognostic value when it comes to long-term physical recovery. Therefore, the objective of this study was to assess the incidence of non-recovery in long-stay ICU-patients. In this single-centre study, retrospective data of adults with an ICU stay >48 hours who visited the specialized post-ICU clinic, and completed the Dutch RAND 36-item Short Form questionnaire at 3 and 12 months post-ICU, were retrieved from electronic patient records. In cases where physical functioning scores at 12 months were below reference values, patients were allocated to the physical non-recovery (NR) group. Significantly different baseline and (post-)ICU-characteristics were assessed for correlations with physical recovery at 12 months post-ICU. Of 250 patients, 110 (44%) fulfilled the criteria for the NR-group. Neither the severity of illness, type of admission, nor presence of sepsis did not differ between groups. However, NR-patients had a higher age, were more often female, and had a higher incidence of co-morbidities. Shorter LOS ICU, lower incidence of medical comorbidities, and better physical performance at 3 months were significantly correlated with 1-year physical recovery. Comorbidities and reduced physical functioning at 3 months were identified as independent risk-factors for long-term physical non-recovery. In conclusion, a substantial proportion of long-stay ICU-patients who visited the standard care post-ICU clinic did not fulfil the criteria for full physical recovery at 12 months post-ICU. Commonly used ICU-characteristics, such as severity of illness, do not have sufficient prognostic value when it comes to long-term recovery of health-related quality of life.
Introduction: Cancer survivors often suffer from fatigue and (mental) health impairments. Despite evidence for effectiveness, lifestyle interventions are seldom applied in their aftercare. The aim of this study was to assess feasibility of a lifestyle intervention program on physical and mental wellbeing and quality of life (QoL) of cancer survivors, and to get a first impression of effectiveness, by means of a pilot study. Methods: Nine subjects were enrolled in a 12-month lifestyle intervention pilot study without a control group, conducted in a Dutch primary care centre. The intervention consisted of individual and group lifestyle training focusing on diet, exercise and mind-body interaction. The main outcomes were physical and mental health and QoL. Results: All 9 subjects completed the 12-month lifestyle intervention program. We found a large positive effect on fatigue (r=-0.9), stress (r=-0.8) and anxiety (r=-0.9). With respect to quality of life, large improvements in vitality (r=0.7), role limitations due to physical health (r=-0.7), role limitations due to emotional problems (r=-0.8) and personal health experience (r=0.8) were found. Subjects' arm strength increased (r=0.9), but there were no significant changes in other physical parameters, depressive symptoms, social optimism and autonomy. Contradictory results were found for pain. Conclusion: Implementation of this lifestyle intervention program seems feasible in this small uncontrolled pilot study. The reduced QoL that is typical for cancer survivors was positively influenced by this program. Most prominent results were retrieved for fatigue and mental functioning, whereas little effects were found for physical health.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.