Department of Mental Health, Metro North Mental Health, Caboolture Hospital, Caboolture, QLD, Australia.
Critical Care Research Group, Adult Intensive Care Service, The Prince Charles Hospital, Brisbane, QLD, Australia.
Crit Care. 2024 Jan 23;28(1):34. doi: 10.1186/s13054-024-04812-7.
Our understanding of post-ICU recovery is influenced by which patients are selected to study and treat. Many studies currently list an ICU length of stay of at least 24, 48, or 72 h as an inclusion criterion. This may be driven by established evidence that prolonged time in an ICU bed and prolonged ventilation can complicate post-ICU rehabilitation. However, recovery after short ICU stays still needs to be explored.
This is a secondary analysis from the tracking outcomes post-intensive care (TOPIC) study. One hundred and thirty-two participants were assessed 6-months post-ICU discharge using standardised and validated self-report tools for physical function, cognitive function, anxiety, depression and post-traumatic stress disorder (with clinically significant impairment on any tool being considered a complicated recovery). Routinely collected data relating to the ICU stay were retrospectively accessed, including length of stay and duration of mechanical ventilation. Patients with short ICU stays were intentionally included, with 77 (58%) participants having an ICU length of stay < 72 h.
Of 132 participants, 40 (30%) had at least one identified post-ICU impairment 6 months after leaving ICU, 22 (17%) of whom had an ICU length of stay < 72 h.
Many patients with an ICU length of stay < 72 h are reporting post-ICU impairment 6 months after leaving ICU. This is a population often excluded from studies and interventions. Future research should further explore post-ICU impairment among shorter stays.
我们对 ICU 后恢复的理解受到所选择的研究和治疗患者的影响。许多研究目前将 ICU 住院时间至少 24、48 或 72 小时列为纳入标准。这可能是因为有既定的证据表明，在 ICU 床上的时间延长和通气时间延长会使 ICU 后康复复杂化。然而，对 ICU 入住时间较短的患者的恢复情况仍需要进一步探讨。
这是跟踪重症监护后结局（TOPIC）研究的二次分析。在 ICU 出院后 6 个月，132 名参与者使用标准化和验证的自我报告工具评估身体功能、认知功能、焦虑、抑郁和创伤后应激障碍（任何工具的临床显著损伤被认为是复杂的恢复）。回顾性地获取与 ICU 入住相关的常规收集数据，包括 ICU 入住时间和机械通气时间。短 ICU 入住时间的患者被故意纳入，其中 77 名（58%）参与者的 ICU 入住时间<72 小时。
在 132 名参与者中，有 40 名（30%）在离开 ICU 后 6 个月至少有一项 ICU 后损伤，其中 22 名（17%）的 ICU 入住时间<72 小时。
许多 ICU 入住时间<72 小时的患者在离开 ICU 后 6 个月报告有 ICU 后损伤。这是一个经常被研究和干预排除在外的人群。未来的研究应进一步探讨较短 ICU 入住时间的 ICU 后损伤。
