Prediction Models for Physical, Cognitive, and Mental Health Impairments After Critical Illness: A Systematic Review and Critical Appraisal

Haines, Kimberley; Hibbert, Elizabeth; McPeake, Joanne; Anderson, Brian J.; Bienvenu, O. Joseph; Andrews, Adair; Brummel, Nathan E.; Ferrante, Lauren E.; Hopkins, Ramona O.; Hough, Catherine L.; Jackson, James C.; Mikkelsen, Mark E.; Leggett, Nina; Montgomery-Yates, Ashley; Sevin, Carla M.; Skidmore, Becky; Still, Mary; Smeden, Maarten van; Collins, Gary S.; Harhay, Michael O.

doi:10.1097/ccm.0000000000004659

Cited by 48 publications

(48 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…50 However, ICU aftercare and followup services can be beneficial to predict and recognise patients (at risk for) with PICS. 8,50 For trauma and cardiac populations, transmural interventions are effective in the form of care pathways, home visit programs, and structured telephone support (STS)in reducing hospital readmissions, reducing pain, improving functional status, and improving disease-specific HRQOL. 51,52 More evidence for transmural interventions for ICU patients and their families are needed as these are needed to prepare patients and especially family members returning to daily life at home in their possible role as a caregiver.…”

Section: Discussionmentioning

confidence: 99%

“…Yet, transitional care interventions as defined by the TCM emphasise streamlined plans of care and continuity of care across settings and between professionals and are not primary focused on patient outcomes. 26 None of the studies had previously selected a risk group for the development of elements of PICS which are important in the development of post-ICU problems, 8,9 which may influence the results. In addition, some studies had a very short ICU admission, and all studies had a relatively short follow-up, which means that possible complaints may not be measurable until later.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

The effects of intensive care unit-initiated transitional care interventions on elements of post-intensive care syndrome: A systematic review and meta-analysis

Hoog

Bruin

Pelgrim

et al. 2022

Australian Critical Care

View full text Add to dashboard Cite

The aim of the study was to assess the effectiveness of intensive care unit (ICU)einitiated transitional care interventions for patients and families on elements of post-intensive care syndrome (PICS) and/or PICS-family (PICSe-F). Review method used: This is a systematic review and meta-analysis Sources: The authors searched in biomedical bibliographic databases including PubMed, Embase (OVID), CINAHL Plus (EBSCO), Web of Science, and the Cochrane Library and included studies written in English conducted up to October 8, 2020. Review methods: We included (non)randomised controlled trials focussing on ICU-initiated transitional care interventions for patients and families. Two authors conducted selection, quality assessment, and data extraction and synthesis independently. Outcomes were described using the three elements of PICS, which were categorised into (i) physical impairments (pulmonary, neuromuscular, and physical function), (ii) cognitive impairments (executive function, memory, attention, visuo-spatial and mental processing speed), and (iii) psychological health (anxiety, depression, acute stress disorder, post-traumatic stress disorder, and depression). Results: From the initially identified 5052 articles, five studies were included (i.e., two randomised controlled trials and three nonrandomised controlled trials) with varied transitional care interventions. Quality among the studies differs from moderate to high risk of bias. Evidence from the studies shows no significant differences in favour of transitional care interventions on physical or psychological aspects of PICS-(F). One study with a nurse-led structured follow-up program showed a significant difference in physical function at 3 months. Conclusions: Our review revealed that there is a paucity of research about the effectiveness of transitional care interventions for ICU patients with PICS. All, except one of the identified studies, failed to

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

The effects of intensive care unit-initiated transitional care interventions on elements of post-intensive care syndrome: A systematic review and meta-analysis

Hoog

Bruin

Pelgrim

et al. 2022

Australian Critical Care

View full text Add to dashboard Cite

show abstract

“…For the modeling of the impact of rehabilitation on the decreased autonomy, baseline and ICU stay characteristics were selected; this selection was based on clinician expertise and prior publication [8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

The Absence of Rehabilitation During the ICU Stay of Elderly Patients is Associated with a Decreased Long-Term Autonomy.

Thiollière¹,

Allaouchiche²,

Marie³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: The intensive care unit (ICU) stay is associated with a loss of autonomy, especially for elderly patients. We therefore conducted a study to estimate the impact of the rehabilitation performed during the ICU stay on the loss of autonomy at 6 months. Methods: We conducted an ancillary study of the multicenter FRAGIREA study, including patients between April 2018 and January 2019 aged over 70 years, admitted in ICU for an expected length of stay of more than 48 hours. We excluded the patients who died before day 180, who were lost to follow-up, and for whom the baseline autonomy (ADL) score was not available. We collected the baseline characteristics of patients, the ICU stay characteristics, and the 6-month follow-up. Were also collected the detailed rehabilitation therapy carried out during the ICU stay (passive mobilization, upright sitting, transfer to chair, standing, walking, and cycle ergometers.). Patients were classified into the rehabilitation (out of bed) or non-rehabilitation group, and the impact of rehabilitation on the decreased 6-month autonomy (loss of ADL score >1 point) was estimated after the selection of 17 potential confounders. Results: Among the 548 patients of the FRAGIREA cohort, 276 were included in the present study. Among them, 226 were rehabilitated and 50 were not. 220/276 (80%) patients benefited from the transfer to chair as rehabilitation therapy, passive mobilization and transfer to upright sitting were also frequently performed. A decrease in the 6-month autonomy was observed for 63 (23%) patients. After the elimination of potential confounders, non-rehabilitated patients had a greater risk of 6-month decreased autonomy (adjusted Odds Ratio 2.43, 95% confidence interval [1.18; 4.98]). Conclusions: Rehabilitation during the ICU stay of elderly ICU patient survivors was associated with a lower decreased autonomy at 6 months. Tweet: The absence of rehabilitation during the ICU stay of elderly patients is associated with 2.4 higher risk of a decreased 6 month autonomy

show abstract

“…Performance on more sensitive tests of cognitive impairment may have predictive value, but these have not been used in prediction focused investigations to date. A recent systematic review highlighted the absence of prediction models for cognitive impairment after surviving critical illness, whereas two studies have predicted physical function and one study predicted mental health disorders 155. The lack of predictive ability restricts the ability of clinicians and researchers to adequately risk stratify patients to their individual rehabilitation needs.…”

Section: Long Term Cognitive Impairmentmentioning

confidence: 99%

Delirium and long term cognition in critically ill patients

Wilcox

Girard

Hough

2021

BMJ

View full text Add to dashboard Cite

Delirium, a form of acute brain dysfunction, is very common in the critically ill adult patient population. Although its pathophysiology is poorly understood, multiple factors associated with delirium have been identified, many of which are coincident with critical illness. To date, no drug or non-drug treatments have been shown to improve outcomes in patients with delirium. Clinical trials have provided a limited understanding of the contributions of multiple triggers and processes of intensive care unit (ICU) acquired delirium, making identification of therapies difficult. Delirium is independently associated with poor long term outcomes, including persistent cognitive impairment. A longer duration of delirium is associated with worse long term cognition after adjustment for age, education, pre-existing cognitive function, severity of illness, and exposure to sedatives. Interestingly, differences in prevalence are seen between ICU survivor populations, with survivors of acute respiratory distress syndrome experiencing higher rates of cognitive impairment at early follow-up compared with mixed ICU survivor populations. Although cognitive performance improves over time for some ICU survivors, impairment is persistent in others. Studies have so far been unable to identify patients at higher risk of long term cognitive impairment; this is an active area of scientific investigation.

show abstract

Prediction Models for Physical, Cognitive, and Mental Health Impairments After Critical Illness: A Systematic Review and Critical Appraisal

Abstract: Supplemental Digital Content is available in the text.

Cited by 48 publications

References 53 publications

The effects of intensive care unit-initiated transitional care interventions on elements of post-intensive care syndrome: A systematic review and meta-analysis

The effects of intensive care unit-initiated transitional care interventions on elements of post-intensive care syndrome: A systematic review and meta-analysis

The Absence of Rehabilitation During the ICU Stay of Elderly Patients is Associated with a Decreased Long-Term Autonomy.

Delirium and long term cognition in critically ill patients

Contact Info

Product

Resources

About