CHEST Guidelines-Long-Term-Outcomes-After-Critical-Care

Long-Term-Outcomes-After-Critical-Care_chest

Pdf Summary

The editorial, authored by Hans Flaatten and Christian Jung, discusses long-term outcomes for patients following critical care in Intensive Care Units (ICUs). The primary focus is on survival with an acceptable quality of life; however, many survivors face increased mortality and reduced quality of life, especially the elderly. Factors influencing these outcomes include age, comorbidities, multimorbidity, frailty, and cognition, many of which are not directly connected to the critical illness itself.<br /><br />Traditional studies emphasize survival, finding that post-discharge patients often experience higher mortality. Recent research has shifted towards understanding the quality of life post-ICU, recognizing the post-intensive-care syndrome and the importance of pre-ICU factors in long-term outcomes.<br /><br />A highlighted study by McPeake et al. uses a prospective method to examine post-hospital ICU survivors' long-term outcomes by comparing them with a non-ICU hospital cohort sourced from the UK Biobank study. The study's findings challenge prior assumptions by showing that after adjusting for initial hospital mortality, long-term survival rates were similar between the ICU and non-ICU groups, though ICU patients exhibited higher healthcare utilization during follow-up.<br /><br />However, the study presents limitations: it primarily includes surgical ICU admissions, potentially skewing results compared to real-time ICU admissions, which offers a mixture of medical and surgical cases. Furthermore, there is a significant time gap between the Biobank study and subsequent hospital admissions, potentially affecting the accuracy of health status assessments. The study also lacks detailed data on ICU resources used and other non-survival outcomes.<br /><br />The editorial underscores the need for more comprehensive studies, possibly using data from ongoing longitudinal health studies worldwide, to better understand the complex nature of post-ICU outcomes.

Keywords

ICU outcomes

quality of life

post-intensive-care syndrome

long-term survival

elderly patients

frailty

comorbidities

healthcare utilization

UK Biobank study

longitudinal health studies