Effects of post-ICU follow-up on subject outcomes: A systematic review and meta-analysis

Rosa, Régis Goulart; Ferreira, Giovanni E; Viola, Thiago Wendt; Robinson, Caroline Cabral; Kochhann, Renata; Berto, Paula Pinheiro; Biason, Livia; Cardoso, Paulo Ricardo Cerveira; Falavigna, Maicon; Teixeira, Cassiano

doi:10.1016/j.jcrc.2019.04.014

Cited by 77 publications

(60 citation statements)

References 45 publications

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“…16 Given the multitude of problems ICU patients have and the lack of a clear/sufficient benefit from post-ICU follow-up, it is necessary to better identify patients in need of this follow-up and, in particular, those who would benefit the most from it. 17,18 Therefore, it is of interest to investigate the characteristics of patients who visit/ do not visit NLCs. According to national recommendations from the Swedish Intensive care Registry (SIR), patients with a length of stay (LOS) of 96 hours or more should be followed-up until more knowledge is available concerning which groups to focus on.…”

Section: Glimelius Petersson Et Almentioning

confidence: 99%

Factors and health‐related quality of life associated with participation in a post‐ICU follow‐up. A register study

Petersson¹,

Jakobsson

Westergren

et al. 2021

Acta Anaesthesiol Scand

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Background: Follow-up for heterogeneous intensive care patients presents challenges for rehabilitation interventions and outcome measurements. The aim was to describe and explore characteristics and determinants for visiting/not visiting a nurse-led clinic (NLC) at different time-points, and to describe physical and mental health (HRQoL) over time. Methods:Patients with a length of stay (LOS) of ≥72 hours, discharged from a general intensive care unit 2004-2014, who participated in a 6-month follow-up programme offering visits to NLC at 2 and 6 months were included. The register study includes information regarding patients' participation in NLC, clinical and demographic data from the Patient Administrative System within Intensive care, and data on 2-, 6-and 12-month HRQoL by using SF-36 from the Swedish Intensive Care Registry.Results: Of 656 patients, 57% visited the NLC on some occasion. These patients were younger (P = .000), had lower Simplified Acute Physiology scores (P = .001) and higher SF-36 physical health domain scores at 2 months (P < .05) compared to those not visiting at all. Visitors at 2 months only were younger, had shorter LOS and higher physical and mental domain scores than patients visiting at 6 months only. Patients visiting the NLC scored significantly higher in all domains from 2 to 12 months, whereas nonvisiting-patients' did this in four out of eight domains during the same time frame. Conclusion:Individual patient's characteristics and current health conditions seem to influence visits to NLC or not. The findings may contribute to the development of existing routines to match the diversity of patients' needs and life situations. | INTRODUC TI ONPost intensive care unit (ICU) follow-up contributes to increased knowledge about patients' needs and recovery after an ICU stay.Patients often report having remaining difficulties caused by the critical illness, treatment and care 1 and may suffer from new or worsening physical, cognitive or mental health problems, collectively named Post Intensive Care Syndrome (PICS). 2 Follow-up clinics may provide opportunities to help patients manage difficulties at different levels of care and at different time points. 3,4 A follow-up service and ICU diary have shown positive effects on posttraumatic stress disorder. 5,6 Patients visiting a nurse-led clinic (NLC) expressed, to a significantly greater extent, that they received advice and information, gained knowledge and re-evaluated memories and experiences from the ICU stay, compared to patients not attending the clinic. 7 However no convincing positive improvements were found regarding Health-Related Quality of Life (HRQoL) in 1 year follow-ups compared to standard care 8,9 or in a recovery programme also measuring sense of coherence and psychological health. 10 Also, systematic reviews have not been able to detect that follow-ups promote recovery. [11][12][13] How to cite this article: Glimelius Petersson C, Jakobsson L, Westergren A, Bergbom I. Factors and health-related quality of life associated wi...

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Section: Glimelius Petersson Et Almentioning

confidence: 99%

Factors and health‐related quality of life associated with participation in a post‐ICU follow‐up. A register study

Petersson¹,

Jakobsson

Westergren

et al. 2021

Acta Anaesthesiol Scand

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“…Although PICS is a well-established finding in non-COVID-19 ARDS patients, its treatment is still under development [ 16 , 17 ]. Randomised controlled trials to date have not shown significant effects of post-ICU rehabilitation and exercise interventions [ 18 – 20 ]. Although patient's characteristics were considered to impact on the outcome of functional exercise performance in a secondary analysis of studies by D enehy and co-workers [ 21 , 22 ], the programme content might be a more critical determinant of the lack of effectiveness.…”

mentioning

confidence: 99%

COVID-19 and pulmonary rehabilitation: preparing for phase three

Polastri¹,

Nava

Clini

et al. 2020

Eur Respir J

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“…Post‐ICU, there are peer support groups and clinics, such as the THRIVE initiative, 11 as well as patient/family education initiatives 8 . Some interventions have improved outcomes, but a recent meta‐analysis showed that observed short‐ and medium‐term benefits do not persist, 12 and a recent Australian national survey demonstrated that only 2% of ICUs offer a post‐ICU clinic to primarily screen for post‐ICU complications and refer on as needed 13 …”

Section: Post‐intensive Care Syndrome – Challenges and Opportunitiesmentioning

confidence: 99%

“…The challenge to the researcher is now to develop a detailed understanding not of “what works in treating PICS” but rather “what works, for whom, and in which circumstances, to deliver their desired outcomes”. The challenge to the clinician is then to identify what underlies his or her individual patient's complicated recovery and which interventions are best suited to help, and when 12 . When a patient has a complicated recovery following ICU stay, the first goal should be to identify the modifiable problems impeding his or her recovery, which will then lead to individualized care.…”

Section: A Way Forwardmentioning

confidence: 99%