Advertisement

Post–intensive care syndrome and health-related quality of life in long-term survivors of intensive care unit

      Abstract

      Objective

      The objective of this study was to provide preliminary data for improving the health-related quality of life of long-term intensive care unit survivors by identifying the relationship between health-related quality of life and post–intensive care syndrome.

      Methods

      Using a descriptive correlation research design, data from patients who visited the outpatient department for continuous treatment after discharge from the intensive care unit were analysed. Post–intensive care syndrome was measured by physical, cognitive, and mental problems. Data were collected from 1st August to 31st December, 2019, and 121 intensive care unit survivors participated in the study.

      Results

      Health-related quality of life showed a negative correlation with physical, mental, and cognitive problems. The factors associated with health-related quality of life were physical and mental problems, education level, sedatives and neuromuscular relaxants, and marital status.

      Conclusions

      To improve the health-related quality of life of intensive care unit survivors, post–intensive care syndrome prevention is important, and a systematic strategy is required through a long-term longitudinal trace study. In addition, intensive care unit nurses and other healthcare professionals need to provide early interventions to reduce post–intensive care syndrome.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Australian Critical Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Lilly C.M.
        • Swami S.
        • Liu X.
        • Riker R.R.
        • Badawi O.
        Five-year trends of critical care practice and outcomes.
        Chest. 2017; 152: 723-735
        • Gajic O.
        • Ahmad S.R.
        • Wilson M.E.
        • Kaufman D.A.
        Outcomes of critical illness: what is meaningful?.
        Curr Opin Crit Care. 2018; 24: 394-400
        • Wang S.
        • Allen D.
        • Kheir Y.N.
        • Campbell N.
        • Khan B.
        Aging and post-intensive care syndrome: a critical need for geriatric psychiatry.
        Am J Geriatr Psychiatr. 2018; 26: 212-221
        • Needham D.M.
        • Davidson J.
        • Cohen H.
        • Hopkins R.O.
        • Weinert C.
        • Wunsch H.
        • et al.
        Improving long-term outcomes after discharge from intensive care unit: report from a stakeholder's conference.
        Crit Care Med. 2012; 40: 502-509
        • Elliott D.
        • Davidson J.E.
        • Harvey M.A.
        • Bemis-Dougherty A.
        • Hopkins R.O.
        • Iwashyna T.J.
        • et al.
        Exploring the scope of post-intensive care syndrome therapy and care: engagement of non-critical care providers and survivors in a second stakeholders meeting.
        Crit Care Med. 2014; 42: 2518-2526
        • Morgan A.
        • O'Connor L.
        Long-term outcomes from critical care.
        Surgery. 2018; 36: 201-204
        • Bakhru R.N.
        • Davidson J.F.
        • Bookstaver R.E.
        • Kenes M.T.
        • Welborn K.G.
        • Morris P.E.
        • et al.
        Physical function impairment in survivors of critical illness in an ICU recovery clinic.
        J Crit Care. 2018; 45: 63-169
        • Lee M.J.
        • Kang J.Y.
        • Jeong Y.J.
        Risk factors for post-intensive care syndrome: a systematic review and meta-analysis.
        Aust Crit Care. 2020; 33: 287-294
        • Wilcox M.
        • Herridge M.S.
        Clinical year in review Ⅲ: mechanical Ventilation acute respiratory distress syndrome nonpulmonary intensive care unit and quality performance assessment metrics in your practice.
        Proc Am Thorac Soc. 2011; 8: 404-410
        • Fan E.
        • Cheek F.
        • Chlan L.
        • Gosselink R.
        • Hart N.
        • Herridge M.S.
        • et al.
        An official American Thoracic Society clinical practice guideline: the diagnosis of Intensive Care Unit-acquired weakness in adults.
        Am J Respir Crit Care Med. 2014; 190: 1437-1446
        • Hermans G.
        • Van Mechelen H.
        • Clerckx B.
        • Vanhullebusch T.
        • Mesotten D.
        • Wilmer A.
        • et al.
        Acute outcomes and 1-year mortality of Intensive Care Unit-acquired weakness A cohort study and propensity-matched analysis.
        Am J Respir Crit Care Med. 2014; 190: 410-420
        • Needham D.M.
        • Wozniak A.W.
        • Hough C.L.
        • Morris P.E.
        • Dinglas V.D.
        • Jackson J.C.
        • et al.
        Risk factors for physical impairment after acute lung injury in a national multicenter study.
        Am J Respir Crit Care Med. 2014; 189: 1214-1224
        • Joffre J.
        • Legrand M.
        Microcirculation-targeted resuscitation in septic shock: can complex problems have simple answers?.
        Ann Intensive Care. 2021; 11: 1
        • Davydow D.S.
        • Hough C.L.
        • Langa K.M.
        • Iwashyna T.J.
        Presepsis depressive symptoms are associated with incident cognitive impairment in survivors of sever sepsis: a prospective cohort study of older Americans.
        J Am Geriatr Soc. 2012; 60: 2290-2296
        • Hong J.H.
        Delirium in the intensive care unit.
        J Neurocrit Care. 2015; 8: 46-52
        • Inoue S.
        • Hatakeyama J.
        • Kondo Y.
        • Hifumi T.
        • Sakuramoto H.
        • Kawasaki T.
        • et al.
        Post-intensive care syndrome: its pathophysiology prevention and future directions.
        Acute Med Surg. 2019; 6: 233-246
        • Needham D.M.
        • Dinglas V.D.
        • Morris P.E.
        • Jackson J.C.
        • Hough C.L.
        • Mendez-Tellez P.A.
        • et al.
        Physical and cognitive performance of patients with acute lung injury 1 year after initial trophic versus full enteral feeding EDEN trial follow-up.
        Am J Respir Crit Care Med. 2013; 188: 567-576
        • Pandharipande P.P.
        • Girard T.D.
        • Jackson J.C.
        • Morandi A.
        • Thompson J.L.
        • Pun B.T.
        • et al.
        Long-term cognitive impairment after critical illness.
        N Engl J Med. 2013; 369: 1306-1316
        • Park J.
        • Jeon K.
        • Chung C.R.
        • Yang J.H.
        • Cho Y.H.
        • Cho J.
        • et al.
        A nationwide analysis of intensive care unit admissions 2009–2014 – the Korean ICU National Date (KIND) study.
        J Crit Care. 2018; 44: 24-30
        • Jackson J.C.
        • Pandharipande P.P.
        • Girard T.D.
        • Brummel N.E.
        • Thompson J.L.
        • Hughes C.G.
        • et al.
        Depression post-traumatic stress disorder and functional disability in survivors of critical illness in the BRAIN-ICU study: a longitudinal cohort study.
        Lancet Respir Med. 2014; 2: 369-379
        • Rawal G.
        • Yadav S.
        • Kumar R.
        Post-traumatic stress disorder: a review from clinical perspective.
        Int J Indian Psychol. 2016; 3: 157-164
        • Wunsch H.
        • Christianes C.F.
        • Johansen M.B.
        • Olsen M.
        • Ali N.
        • Angus D.C.
        • et al.
        Psychiatric diagnoses and psychoactive medication use among nonsurgical critically ill patients receiving mechanical ventilation.
        JAMA. 2014; 311: 1133-1142
        • Geense W.W.
        • Zegers M.
        • Peters M.A.A.
        • Ewalds E.
        • Simons K.S.
        • Vermeulen H.
        • et al.
        New physical mental and cognitive problems 1-year post-ICU: a prospective multicenter study.
        Am J Respir Crit Care Med. 2021; 203: 1512-1521
        • Seppänen P.
        • Sund R.
        • Ala-Kokko T.
        • Roos M.
        • Uotila J.
        • Helminen M.
        • et al.
        Obstetric patients' health-related quality of life before and after intensive care.
        Aust Crit Care. 2019; 32: 116-121
        • Gerth A.M.J.
        • Hatch R.A.
        • Young J.D.
        • Watkinson P.J.
        Changes in health-related quality of life after discharge from an intensive care unit: a systematic review.
        Anaesthesia. 2019; 74: 100-108
        • Wang L.
        • Palmer A.J.
        • Cocker F.
        • Sanderson K.
        Multimorbidity and health-related quality of life(HRQoL) in a nationally representative population sample: implications of count versus cluster method for defining multimorbidity on HRQoL.
        Health Qual Life Outcome. 2017; 15: 7
        • Cha H.J.
        • Ahn S.H.
        Impact of environmental stressors on the risk for posttraumatic stress disorder and quality of life in Intensive Care Unit survivors.
        J Korean Crit Care Nurs. 2019; 12: 22-35
        • Kang J.Y.
        Sentiment analysis of the quotations of Intensive Care Unit survivors in qualitative studies.
        J Korean Crit Care Nurs. 2018; 11: 1-14
        • Bhat G.
        • Yost G.
        • Mahoney E.
        Cognitive function and left ventricular assist device implantation.
        J Heart Lung Transplant. 2015; 34: 1398-1405
        • Serrano P.
        • Kheir Y.N.P.
        • Wang S.
        • Khan S.
        • Scheunemann L.
        • Khan B.
        Aging and postintensive care syndrome- family: a critical need for geriatric psychiatry.
        Am J Geriatr Psychiatr. 2019; 27: 446-454
        • Jo M.W.
        • Ahn J.H.
        • Kim S.H.
        • Shin S.J.
        • Park J.Y.
        • Ok M.S.
        • et al.
        The valuation of EQ-5D-5L health states in Korean.
        Natl Evid Based Healthcare Collab Agency. 2014; 1: 1-122
        • Won C.W.
        • Rho Y.G.
        • Kim S.Y.
        • Cho B.R.
        • Lee Y.S.
        The validity and reliability of Korean Activities of Daily Living (K-ADL) scale.
        J Korean Geriatr Soc. 2002; 6: 98-106
        • Won C.W.
        • Rho Y.G.
        • Sunwoo D.
        • Lee Y.S.
        The validity and reliability of Korean instrumental activities of daily living (K-IADL) scale.
        J Korean Geriatr Soc. 2002; 6: 273-280
        • Nasreddine Z.S.
        • Phillips N.A.
        • Bédirian V.
        • Charbonneau S.
        • Whitehead V.
        • Collin I.
        • et al.
        The Montreal cognitive assessment MoCA: a brief screening tool for mild cognitive impairment.
        J Am Geriatr Soc. 2005; 53: 695-699
        • Kang Y.W.
        • Park J.S.
        • Yu K.H.
        • Lee B.C.
        A reliability validity and normative study of the Korean-Montreal cognitive assessment (K-MoCA) as an instrument for screening of vascular cognitive impairment (VCI).
        Kor J Clin Psychol. 2009; 28: 549-562
        • Weather F.W.
        • Litz B.T.
        • Herman D.S.
        • Huska J.A.
        • Keane T.M.
        The PTSD checklist (PCL): reliability validity and diagnostic utility in: text annual convention of the international society for traumatic stress studies.
        1993: 462 (San Antonio)
        • Kim J.W.
        • Chung H.G.
        • Choi J.H.
        • So H.S.
        • So H.S.
        • Kang S.H.
        • et al.
        Psychometric properties of the Korean version of the PTSD check list-5 in elderly Korean veterans of the vietnam war.
        Anxiety Mood. 2017; 13: 123-131
        • Kang J.Y.
        • Yi B.K.
        Risk factors for cognitive impairment in intensive care unit survivors.
        J Korean Crit Care Nurs. 2020; 13: 75-85
        • Kim S.K.
        • Kang J.Y.
        Post-intensive care syndrome and quality of life in survivors of critical illness.
        J Korean Crit Care Nurs. 2016; 9: 1-14
      1. Nam HJ, Hwang SH, Kim YJ, Kim KW. Korean dementia observatory 2018. National Institute of Dementia. Seoul. P. 64

        • Jung C.R.
        Status of rehabilitation of critical illness patients.
        Korean J Med. 2019; 2: 680-683
        • Kim S.H.
        • Ju H.O.
        Influential factors of post-traumatic stress disorder in survivors of intensive care units.
        J Korean Clin Nurs Res. 2020; 26: 97-106
        • Ramnarain D.
        • Rutten A.
        • Van der Nat G.
        • Van Gorp J.
        • Gnirrep I.
        • Voermans-Schellekens S.
        • et al.
        The impact of post intensive care syndrome in patients surviving the ICU: the downside of ICU treatment.
        Intensive Care Med Exp. 2015; 3: 1-2
        • Zetterlund P.
        • Plos K.
        • Bergbom I.
        • Ringdal M.
        Memories from intensive care unit persist for several years -A longitudinal prospective multi-center study.
        Intensive Crit Care Nurs. 2012; 28: 159-167
        • Lee S.B.
        • Hur N.W.
        A study on the determinations of the elderly's ADL/IADL: focused on the comparison of Urban and Rural Areas.
        J Korea Acad-Ind. 2021; 22: 419-429
        • Sacanella E.
        • Pérez-Castejón J.M.
        • Nicolás J.M.
        • Masanés F.
        • Navarro M.
        • Castro P.
        • et al.
        Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study.
        Crit Care. 2011; 15: R105
        • Bienvenu O.J.
        • Colantuoni E.
        • Mendez-Tellez P.A.
        • Shanholtz C.
        • Dennison-Himmelfarb C.R.
        • Pronovost P.J.
        • et al.
        Co-occurrence of and remission from general anxiety depression and posttraumatic stress disorder symptoms after acute lung injury: a 2-year longitudinal study.
        Crit Care Med. 2015; 43: 642-653
        • Kim W.
        Rehabilitation in intensive care unit.
        J Acute Care Surg. 2018; 8: 2-6
        • da Costa J.B.
        • Taba S.
        • Scherer J.R.
        • Oliveira L.L.F.
        • Luzzi K.C.B.
        • Gund D.P.
        • et al.
        Psychological disorders in post-ICU survivors and impairment in quality of life.
        Psychol Neurosci. 2019; 12: 391-406
        • Parker A.M.
        • Sricharoenchai T.
        • Raparla S.
        • Schneck K.W.
        • Bienvenu O.J.
        • Needham D.M.
        Posttraumatic stress disorder in critical illness survivors: a metaanalysis.
        Crit Care Med. 2015; 43: 1121-1129
        • Morina N.
        • Wicherts J.M.
        • Lobbrecht J.
        • Priebe S.
        Remission from post-traumatic stress disorder in adults: a systematic review and meta-analysis of long term outcome studies.
        Clin Psychol Rev. 2014; 34: 249-255
        • Santiago P.N.
        • Ursano R.J.
        • Gray C.L.
        • Pynoos R.S.
        • Spiegel D.
        • Lewis-Fernandez R.
        • et al.
        A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: intentional and non-intentional traumatic events.
        PLoS One. 2013; 859236
        • Kwak H.S.
        • Kim S.H.
        The normative study of the Montreal cognitive assessment-Korea (MoCA-K) as instrument for screening of mild cognitive impairment (MCI).
        J Korean Soc Integr Med. 2021; 9: 37-45
        • Marra A.
        • Pandharipande P.P.
        • Girard T.D.
        • Patel M.B.
        • Hughes C.G.
        • Jackson J.C.
        • et al.
        Co-occurrence of post-intensive care syndrome problems among 406 survivors of critical illness.
        Crit Care Med. 2018; 46: 1393-1401
        • van Der Wal M.H.
        • Jaarsma T.
        • Moser D.K.
        • Veeger N.J.
        • van Gilst W.H.
        • van Veldhuisen D.J.
        Compliance in heart failure patients: the importance of knowledge and beliefs.
        Eur Heart J. 2006; 27: 434-440
        • Devlin J.W.
        • Skrobik Y.
        • Gélinas C.
        • Needham D.M.
        • Slooter A.J.C.
        • Pandharipande P.P.
        • et al.
        Clinical practice guidelines for the prevention and management of pain agitation/sedation delirium immobility and sleeping disruption in adult patients in the ICU.
        Crit Care Med. 2018; 46: e825-e873
        • Namigar T.
        • Serap K.
        • Esra A.T.
        • Özgül O.
        • Can Ö.A.
        • Aysel A.
        • et al.
        The correlation among the Ramsay sedation scale Richmond agitation sedation scale and Riker sedation agitation scale during midazolam-remifentanil sedation.
        Rev Bras Anestesiol. 2017; 67: 347-354
        • Pandharipande P.P.
        • Girard T.D.
        • Ely E.W.
        Long-term cognitive impairment after critical illness.
        N Engl J Med. 2014; 370: 185-186
        • Yao L.
        • Li Y.
        • Yin R.
        • Yang L.
        • Ding Li
        • Li B.
        • et al.
        Incidence and influencing factors of post-intensive care cognitive impairment.
        Intensive Crit Care Nurs. 2021; 67: 103-106
        • Baron R.
        • Binder A.
        • Biniek R.
        • Braune S.
        • Buerkle H.
        • Dall P.
        • et al.
        Evidence and consensus based guideline for the management of delirium analgesia and sedation in intensive care medicine 2015 revision (DAS Guideline 2015) - short version.
        Ger Med Sci. 2015; 13
        • Hodgson C.L.
        • Udy A.A.
        • Bailey M.
        • Barrett J.
        • Bellomo R.
        • Bucknall T.
        • et al.
        The impact of disability in survivors of critical illness.
        Intensive Care Med. 2017; 43: 992-1001
        • Neuman M.D.
        • Werner R.M.
        Marital status and postoperative functional recovery.
        JAMA Surg. 2016; 151: 194-196
        • Monin J.K.
        • Levy B.
        • Doyle M.
        • Schulz R.
        • Kershaw T.
        The impact of both spousal caregivers' and care recipients' health on relationship satisfaction in the Caregiver Health Effects Study.
        J Health Psychol. 2019; 24: 1744-1755