Tanaka Kohei, Nakanishi Nobuto, Liu Keibun, Miyamoto Kyohei, Kawauchi Akira, Okamura Masatsugu, Katayama Sho, Iida Yuki, Kawai Yusuke, Hatakeyama Junji, Hifumi Toru, Unoki Takeshi, Kawakami Daisuke, Amaya Fumimasa, Obata Kengo, Sumita Hidenori, Morisawa Tomoyuki, Tsuboi Norihiko, Kozu Ryo, Takaki Shunsuke, Haruna Junpei, Ota Kohei, Fujinami Yoshihisa, Nosaka Nobuyuki, Shirasaki Kasumi, Inoue Shigeaki, Nishida Osamu, Nakamura Kensuke
Department of Rehabilitation Medicine, Osaka International Medical & Science Center, 2-6-40 Karasugatsuji, Tennoji-Ku, Osaka, 543-8922, Japan.
Division of Disaster and Emergency Medicine, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.
J Intensive Care. 2025 Aug 18;13(1):45. doi: 10.1186/s40560-025-00817-8.
Since the concept of post-intensive care syndrome (PICS) was proposed, numerous studies have assessed patients and their family members. However, a wide range of assessment timings has been employed across previous studies. This study aimed to clarify how assessment timings have been implemented in existing PICS research through a scoping review, and to explore expert opinions on optimal assessment timing via an online survey.
We conducted a scoping review of studies assessing PICS-related outcomes, including physical, cognitive, and psychological impairments, as well as PICS in family members. Studies were retrieved from MEDLINE, CENTRAL, and CINAHL, and screened by two independent pairs of reviewers. Eligible studies were published between January 2014 and December 2022. Studies lacking a clear description of assessment timing were excluded. We analyzed the reference point used to determine assessment schedules, the assessment time points, and their frequency. Additionally, an online questionnaire was administered to 23 members of the Japanese Society of Intensive Care Medicine PICS committee and working group members to collect expert opinions on these three aspects for clinical research.
A total of 657 studies were included. In prior studies, hospital discharge was the most commonly used reference point for determining assessment schedule (240 studies, 40%). However, ICU discharge was identified by experts as the ideal reference point (16 votes, 47%). The most frequently used assessment time points were 3 months (262, 23%), 6 months (212, 19%), and 12 months (206, 18%) post-discharge. Experts most commonly selected the period between 6 and 12 months as the optimal time point for assessment. While single assessments were most common in previous studies (337, 51%), experts considered three assessments to be ideal (12, 44%).
This study revealed notable discrepancies between the assessment timing reported in previous studies and the opinions of experts regarding optimal timing. Standardization of assessment timing in PICS research is warranted to enhance methodological consistency and comparability.
自从提出重症监护后综合征（PICS）的概念以来，众多研究对患者及其家庭成员进行了评估。然而，以往的研究采用了广泛的评估时间。本研究旨在通过范围综述阐明现有PICS研究中评估时间是如何实施的，并通过在线调查探索关于最佳评估时间的专家意见。
我们对评估PICS相关结局的研究进行了范围综述，这些结局包括身体、认知和心理损伤以及家庭成员中的PICS。研究从MEDLINE、CENTRAL和CINAHL中检索，并由两对独立的评审员进行筛选。符合条件的研究发表于2014年1月至2022年12月之间。缺乏评估时间明确描述的研究被排除。我们分析了用于确定评估时间表的参考点、评估时间点及其频率。此外，向日本重症监护医学协会PICS委员会的23名成员和工作组成员发放了一份在线问卷，以收集他们对临床研究这三个方面的专家意见。
共纳入657项研究。在先前的研究中，出院是确定评估时间表最常用的参考点（240项研究，40%）。然而，专家们将重症监护病房（ICU）出院确定为理想的参考点（16票，47%）。最常用的评估时间点是出院后3个月（262项，23%）、6个月（212项，19%）和12个月（206项，18%）。专家们最常选择6至l2个月之间作为最佳评估时间点。虽然在先前的研究中单次评估最为常见（337项，51%），但专家们认为三次评估是理想的（12票，44%）。
本研究揭示了先前研究报告的评估时间与专家关于最佳时间的意见之间存在显著差异。PICS研究中评估时间的标准化对于提高方法的一致性和可比性是必要的。
