A Call for the World Health Organization to Create International Classification of Disease Diagnostic Codes for Post‐Intensive Care Syndrome in the Age of COVID‐19

Peach, Brian C.; Valenti, Michael; Sole, Mary Lou

doi:10.1002/wmh3.401

Cited by 19 publications

(17 citation statements)

References 42 publications

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“…A definition founded in the umbrella term postulated by the Society of Critical Care Medicine in 2012 [2] and applied in recent publications in absence of alternative diagnostic tools [33,52,53]. As no diagnostic tools for PICS exist at this moment [54], the population in our study cannot be formally identified as having PICS, although our secondary outcome data show that participants experienced impairments in physical, psychological, and/or cognitive domains. Clinical tools are needed to identify the presence of PICS and the extent of PICS-related disability, and although recently the development and validation of some tools have been investigated, further studies are urgently needed for better definition and understanding of PICS [54][55][56][57][58].…”

Section: Discussionmentioning

confidence: 91%

“…Clinical tools are needed to identify the presence of PICS and the extent of PICS-related disability, and although recently the development and validation of some tools have been investigated, further studies are urgently needed for better definition and understanding of PICS [54][55][56][57][58]. Working with the limitation of a not clearly defined population, we designed a patient-centered intervention embedded within an interdisciplinary collaborative network addressing the complex cluster of problems in patients with PICS conform recent recommendations [12,33,54].…”

Section: Discussionmentioning

confidence: 99%

“…As our study shows, a larger number of visits to expensive medical specialist care (secondary or tertiary line of care) was reported within the usual care group when compared to REACH, while a smaller number of participants reported a higher total of PT sessions in the usual care group, which could be indicative of inefficiently organized healthcare. Current national initiatives towards guideline development and recommendations for recognition of PICS with an ICD-10 code will hopefully pave the way for efficient and equitable health care [54,63,64].…”

Section: Discussionmentioning

confidence: 99%

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Feasibility of a home-based interdisciplinary rehabilitation program for patients with Post-Intensive Care Syndrome: the REACH study

et al. 2021

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Background Survivors of critical illness experience long-term functional challenges, which are complex, heterogeneous, and multifactorial in nature. Although the importance of rehabilitation interventions after intensive care unit (ICU) discharge is universally recognized, evidence on feasibility and effectiveness of home-based rehabilitation programs is scarce and ambiguous. This study investigates the feasibility of an interdisciplinary rehabilitation program designed for patients with Post-Intensive Care Syndrome (PICS) who are discharged home. Methods A mixed method, non-randomized, prospective pilot feasibility study was performed with a 6-month follow-up, comparing the intervention (REACH) with usual care. REACH was provided by trained professionals and included a patient-centered, interdisciplinary approach starting directly after hospital discharge. Primary outcomes were patient safety, satisfaction, adherence, referral need and health care usage. Secondary outcomes, measured at 3 timepoints, were functional exercise capacity, self-perceived health status, health-related quality of life (HRQoL), return to work and psychotrauma. Risk of undernutrition was assessed at baseline. Results 43 patients with a median mechanical ventilation duration of 8 (IQR:10) days, were included in the study and 79.1% completed 6-month follow-up. 19 patients received the intervention, 23 received usual care. Groups were similar for gender distribution and ICU length of stay. No adverse events occurred. REACH participants showed higher satisfaction with treatment and reported more allied health professional visits, while the usual care group reported more visits to medical specialists. Qualitative analysis identified positive experiences among REACH-professionals related to providing state-of-the-art interventions and sharing knowledge and expertise within an interprofessional network. Similar recovery was seen between groups on all secondary outcomes, but neither group reached reference values for HRQoL at 6 months. Larger return to work rates were seen in the REACH group. Prevalence of undernutrition at hospital discharge was high in both groups (> 80%), warranting the need for careful tuning of physical therapy and nutritional interventions. Conclusions This study shows that providing early, home-based rehabilitation interventions for patients with PICS-related symptoms is feasible and perceived positively by patients and professionals. When provided in an interdisciplinary collaborative network state of the art, person-centered interventions can be tailored to individual needs potentially increasing patient satisfaction, adherence, and efficacy. Registered in the Dutch Trial register: NL7792: https://www.trialregister.nl/trial/7792, registered 7-06-2019.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Feasibility of a home-based interdisciplinary rehabilitation program for patients with Post-Intensive Care Syndrome: the REACH study

et al. 2021

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“…When HRQOL was assessed in a case series of post-ICU COVID-19 cases, they all showed impairment when assessed with the use of the SF 36 at 3 months [135]. A call has already been made to the World Health Organization (WHO) to develop International Classification of Disease Diagnostic Codes for PICS in the "Age of COVID-19" [136]. Follow-ups of these patients in post-ICU clinics and in primary care are paramount and, in many cases, must be performed with virtual visits, and support of patients and families must be provided through the internet [137].…”

Section: Covid-19-related Picsmentioning

confidence: 99%

Post-Intensive Care Syndrome in Survivors from Critical Illness including COVID-19 Patients: A Narrative Review

Vrettou

Mantziou

Vassiliou

et al. 2022

Life

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Current achievements in medical science and technological advancements in intensive care medicine have allowed better support of critically ill patients in intensive care units (ICUs) and have increased survival probability. Post-intensive care syndrome (PICS) is a relatively new term introduced almost 10 years ago, defined as “new or worsening impairments in physical, cognitive, or mental health status arising after critical illness and persisting beyond acute care hospitalization”. A significant percentage of critically ill patients suffer from PICS for a prolonged period of time, with physical problems being the most common. The exact prevalence of PICS is unknown, and many risk factors have been described well. Coronavirus disease 2019 (COVID-19) survivors seem to be at especially high risk for developing PICS. The families of ICU survivors can also be affected as a response to the stress suffered during the critical illness of their kin. This separate entity is described as PICS family (PICS-F). A multidisciplinary approach is warranted for the treatment of PICS, involving healthcare professionals, clinicians, and scientists from different areas. Improving outcomes is both challenging and imperative for the critical care community. The review of the relevant literature and the study of the physical, cognitive, and mental sequelae could lead to the prevention and timely management of PICS and the subsequent improvement of the quality of life for ICU survivors.

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“…Therefore, follow-up of the critically ill patients who survived COVID-19 which is thought to have long-term effects on patients, should be systematically performed from this point of view by all aspects. Considering that PICS do not even have an International Classification of Disease Diagnostic (ICD) Code yet, it has been suggested that an ICD code should be created for PICS within the era of COVID-19 pandemic [47]. 3…”

Section: Discussionmentioning

confidence: 99%

Implementation of post-intensive care outpatient clinic (I-POINT) for critically ill COVID-19 survivors

Halaçlı¹,

Topeli²

2021

Turk J Med Sci

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Although we have enough and cumulative information about acute effects of COVID-19, our knowledge is extremely limited about long-term consequences of COVID-19, in terms of its impacts and burdens on patients, families, and the health system. Considering the underlying pathophysiological mechanisms affecting all of the organ systems in critically ill COVID-19 patients who are admitted to intensive care units, the development of post-intensive care syndrome is inevitable. This situation brings along the development of long-COVID. These patients should be followed regarding cognitive, physical, and psychiatric aspects and necessary specialist referrals should be carried out. In this article, we are presenting the experience and recommendations of our center, as a guide for the establishment process of post-intensive care outpatient clinics for the critically ill patients who required intensive care admission due to COVID-19 and could be discharged.

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A Call for the World Health Organization to Create International Classification of Disease Diagnostic Codes for Post‐Intensive Care Syndrome in the Age of COVID‐19

Cited by 19 publications

References 42 publications

Feasibility of a home-based interdisciplinary rehabilitation program for patients with Post-Intensive Care Syndrome: the REACH study

Feasibility of a home-based interdisciplinary rehabilitation program for patients with Post-Intensive Care Syndrome: the REACH study

Post-Intensive Care Syndrome in Survivors from Critical Illness including COVID-19 Patients: A Narrative Review

Implementation of post-intensive care outpatient clinic (I-POINT) for critically ill COVID-19 survivors

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