With the increasing survival rates in the ICU, there is more focus on improving the quality of survival. Post-intensive care syndrome (PICS), characterised by cognitive, psychological, and physical impairments affecting up to 80% of ICU survivors, remains a significant challenge despite extensive research. Identifying the risk factors and understanding how they affect recovery is crucial for developing effective prevention and treatment strategies.
However, current research often excludes patients with short ICU stays, assuming a lower risk of PICS. This assumption needs to be challenged, as even short ICU stays may lead to post-ICU impairment. Many patients discharged from ICUs after brief stays and short periods of mechanical ventilation experience post-ICU impairments despite often being excluded from research and follow-up services. While longer ICU stays and ventilation durations remain significant risk factors for PICS, it's crucial not to overlook the morbidity faced by patients with shorter stays. The factors contributing to PICS in these cases may differ, including pre-ICU, in-ICU, and post-ICU factors.
How post-ICU recovery is perceived is shaped by the patients chosen for research and treatment. Current studies often focus on patients with longer ICU stays, likely due to the known complications associated with prolonged time in the ICU and on ventilation. However, there's also a need to investigate recovery after shorter ICU stays.
The Tracking Outcomes Post-Intensive Care (TOPIC) study investigates impairments in 132 participants assessed six months post-ICU discharge. Standardised self-report tools were used to evaluate physical function, cognitive function, anxiety, depression, and post-traumatic stress disorder. Data on ICU stay, including length and duration of mechanical ventilation, were retrospectively collected. The study intentionally included patients with short ICU stays, with 58% of participants having a stay of less than 72 hours.
Out of the 132 participants, 40 (30%) showed at least one post-ICU impairment six months after discharge, with 22 (17%) of them having had an ICU stay of less than 72 hours.
Given the considerable prevalence of PICS among patients with short ICU stays, they must be included in future research and treatment efforts to address this overlooked burden of morbidity.
Source: Critical Care
Image Credit: iStock
