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Patient-Centered Outcomes in Critical Illness: Will My Patient Be Functionally and Cognitively Intact?
Jacqueline H Geer1, Wei Qi2, Lauren E Ferrante1
1Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
Seminars in Respiratory and Critical Care Medicine
|December 12, 2019
Summary
Millions of patients now survive intensive care unit (ICU) stays, but many face long-term physical and cognitive challenges. Understanding factors influencing these outcomes is crucial for patient recovery and quality of life.
Area of Science:
- Critical Care Medicine
- Neurocritical Care
- Rehabilitation Medicine
Background:
- Increasing survival rates in intensive care units (ICUs) highlight the growing population of critically ill survivors.
- ICU survivors frequently experience significant long-term impairments in physical, cognitive, and mental health domains.
- Patient-centered outcomes, particularly functional and cognitive status, are prioritized by patients over mortality.
Purpose of the Study:
- To explore the key determinants affecting functional and cognitive outcomes following critical illness.
- To address the clinical question regarding the likelihood of functional and cognitive intactness in ICU survivors.
Main Methods:
- Review of landmark studies and existing literature on post-ICU outcomes.
- Discussion of factors influencing physical, cognitive, and mental health sequelae.
- Analysis of patient treatment preferences emphasizing functional and cognitive recovery.
Main Results:
- Critical illness survivors face a high risk of persistent physical and cognitive deficits.
- Patient values indicate a strong preference for preserving functional and cognitive abilities.
- Multiple factors contribute to the variability in post-ICU functional and cognitive recovery.
Conclusions:
- Focusing on determinants of functional and cognitive outcomes is essential for improving long-term patient well-being.
- Proactive strategies addressing physical and cognitive impairments should be integrated into critical care.
- Further research is needed to optimize recovery trajectories for intensive care unit survivors.
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