Consequences of a stay in the intensive care unit and outpatient follow-up care for chronic critically ill patients: A retrospective data analysis.

Autor: Maurer C; Bern University of Applied Sciences, Department of Health Professions, Murtenstrasse 10, 3008 Bern, Switzerland. Electronic address: carol.maurer@localmed.ch., Exl MT; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: Matthias.Exl@insel.ch., Gander HP; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: Hans-Peter.Gander@insel.ch., Bertschi D; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: Daniela.Bertschi@insel.ch., Fischbacher I; Department of Health, Eastern Switzerland University of Applied Sciences, Rosenbergstrasse 59, 9000 St.Gallen, Switzerland; Health Department of St.Gallen, Service for Care and Development, Oberer Graben 32, 9001 St.Gallen, Switzerland. Electronic address: irene.fischbacher@ost.ch., Barbezat I; Bern University of Applied Sciences, Department of Health Professions, Murtenstrasse 10, 3008 Bern, Switzerland; Clinical Practice Development, Department of Nursing, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: Isabelle.Barbezat@insel.ch., Eissler C; Bern University of Applied Sciences, Department of Health Professions, Murtenstrasse 10, 3008 Bern, Switzerland. Electronic address: Christian.eissler@bfh.ch., Jeitziner MM; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; Institute of Nursing Science (INS), Department of Public Health (DPH), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland. Electronic address: Marie-Madlen.Jeitziner@insel.ch.
Jazyk: angličtina
Zdroj: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses [Aust Crit Care] 2024 Nov; Vol. 37 (6), pp. 931-939. Date of Electronic Publication: 2024 Jul 06.
DOI: 10.1016/j.aucc.2024.05.011
Abstrakt: Background: Patients with chronic critical illness (CCI) represent a particularly vulnerable patient population with significant quality-of-life consequences and a need for follow-up care. Existing research on their quality-of-life trajectory and outpatient follow-up care is limited.
Objectives: The aim of this study was to (i) describe a quality improvement project focussing on patients with CCI in the Swiss setting; (ii) explain the consequences of an intensive care unit (ICU) stay for patients with CCI; and (iii) evaluate outpatient follow-up care for patients with CCI.
Methods: This retrospective descriptive mixed-methods longitudinal study used routine data from outpatient follow-up care between October 2018 and June 2022. The pre-ICU data were collected retrospectively for the week before ICU admission (baseline); prospectively at 3, 6, and 12 months after ICU discharge; and during an outpatient follow-up care at 6 months. Its main outcomes were health-related quality of life (HRQOL). Patients with CCI were defined as those having a ICU stay longer than 7 days.
Results: This study enrolled 227 patients with outpatient follow-up care, but only 77 were analysed at all four timepoints. Their EuroQol five-dimension five-level questionnaire-Visual Analogue Scale scores ranged from 0 to 100, with a median of 85 (interquartile range = 0-100) and a mean of 77.2 (standard deviation ± 23.52) before their ICU stay. Their scores had almost returned to the baseline 12 months after their ICU stay. While some reported existing restrictions in the individual HRQOL dimensions before their ICU stay, patients and their families appreciated the outpatient follow-up care including an ICU visit.
Conclusion: Patients with CCI have different HRQOL trajectories over time. Patients with CCI can have a good HRQOL despite their impairments; however, the HRQOL trajectories of many patients remain unclear. The focus must be on identifying the illness trajectories and on measuring and maintaining their long-term HRQOL.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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