Hospital patients who are discharged from an ICU event often suffer long-term negative outcomes that are considered a Post Intensive Care Syndrome (PICS). The term “PICS” represents having one or more problems with mental, cognitive, and physical functioning after a critical illness. Common issues include financial difficulties, restrictions in societal participation and decreased quality of life. This was the subject of a recent study published in Critical Care Medicine in which the researchers set out to determine the prevalence of chronic conditions within the total ICU population before ICU admission, the types of chronic conditions ICU patients suffer, and the risk of developing new chronic conditions after ICU discharge.
The researchers combined a national health insurance claims database and a national quality registry for ICUs from 2012–2014 and combined that with clinical data of patients who had been admitted to a total of 81 Dutch ICUs during 2013.
The aim of this study was: 1) to describe the types and prevalence of chronic conditions in an ICU population and a population-based control group during the year before ICU admission and 2) to quantify the risk of developing new chronic conditions in ICU patients and the population-based control group during the year after ICU admission.
Key findings of the analysis include:
- ICU patients have more chronic conditions during the year before ICU admission compared with a population-based control group.
- ICU survivors without preexisting chronic conditions were five-fold more likely to develop a chronic condition compared with surviving control patients without preexisting chronic conditions.
- Additional chronic conditions increase complexity of care for patients surviving critical illness or injury.
Women in the ICU also have a higher prevalence of chronic conditions at baseline compared with men, according to the study. However, among both genders, men had higher estimated risk of developing new chronic conditions compared with women. The researchers suggest this may be because women in general tend to seek primary care services more often than men and therefore are diagnosed earlier as chronic conditions are primarily diagnosed and managed by GPs.
“Due to the high prevalence of chronic conditions and the increased risk of developing new chronic conditions, ICU follow-up care is advised and may focus on the identification and treatment of the new developed chronic conditions,” the authors wrote. “These data support the need for routine ICU follow-up to assist with assessment of chronic condition persistence, severity, impact on cognitive and motor function, and coordination of healthcare.”
