Quality of Life Clinical Trial
Official title:
Recovery After ICU Treatment: A Prospective Cohort Study
This project aims to investigate the physical, mental and cognitive recovery after admission
to the Intensive Care Unit (ICU).
This will be done by a three and 12 month follow up after discharge. The patients will be
scored with four validated methods for evaluating their health related quality of life,
anxiety and depression, cognitive function and physical impairments
An increasing number of patients are treated at ICUs worldwide. The majority of these
patients survive critical illness and are discharged from the hospital. A stay at the ICU is
most often related to life-threatening conditions and displays a major impact on both
physical and mental resources of the patients. Studies have shown that a great part of these
patients also have physical and psychological impairments lasting for a long period after
their hospital stay. The condition is termed the "post intensive care syndrome" (PICS) and
describes a state with wide range of symptoms as fatigue, depression, anxiety, memory loss as
well as both cognitive and physical impairment. During the first five years after discharge,
more than half of ICU survivors had suffered at least one episode of depression or anxiety
ICU treatment often involves immobilization and sedation that may lead to both muscle
weakness, critical illness myopathy and/or polyneuropathy. This may not only affect the
patients during the ICU or hospital stay, but also for a longer post-discharge period. A
recent study demonstrated that measured physical health related quality of life was impaired
for up to one year after hospitalization, and that the physical performance at five years
post-discharge continued to be lower than in the background population. The physical
impairments may also influence patient's working ability, and among previously working
individuals only half had returned to work within the first year after ICU hospitalization.
After five years, up to 25 % still had not returned to work.
In Denmark, more than 30.000 people are annually admitted to intensive care units. The annual
report from the Danish Intensive Care Database (DID) present data regarding a variety of
outcomes, including length of stay, survival rate and 90 days re-admission to hospital. The
reports demonstrate an increased quality of care but offer limited information on longer term
outcome including quality of life for these patients. A recent study have indicated that
Danish patients might suffer from the same psychological and physical impairments as found in
international studies, but a better characteristic of the population is needed. Especially
since the level of public care, including early rehabilitation in hospital differs between
countries.
It is therefore essential to investigate and describe the needs, standard of care and the
physical and cognitive status of these patients both in-hospital and post-discharge in order
to establish the right level of aftercare for the Danish population. This study aims at
investigating the in-hospital care as well as the physical and cognitive status of a Danish
cohort of ICU patients at 3 and 12 month post-discharge.
The investigators plan to do a substudy regarding exposure to circadian light and delirium.
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