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Long-Term Outcomes of Persistent Critical Illness
Louisa W J He1, Ary Serpa Neto1,2,3,4, Alisa M Higgins1,5
1Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Annals of the American Thoracic Society
|August 14, 2025
Summary
Persistent critical illness (PerCI) patients face higher risks of death or disability post-ICU. Survivors show significant functional recovery between three and six months, indicating potential for improvement.
Area of Science:
- Critical Care Medicine
- Intensive Care Unit (ICU) Outcomes
- Long-term Patient Recovery
Background:
- Persistent critical illness (PerCI) affects a growing ICU patient population with prolonged critical illness.
- These patients consume significant healthcare resources, but long-term functional outcomes remain poorly understood.
- Understanding outcomes in PerCI is crucial for resource allocation and patient care planning.
Purpose of the Study:
- To compare the incidence of death or new disability at six months in ICU patients with and without PerCI.
- To define PerCI as a critical illness persisting for at least 10 days in the ICU.
- To assess long-term functional outcomes and recovery trajectories in critically ill patients.
Main Methods:
- Secondary analysis of a multi-center, prospective cohort study involving adults on mechanical ventilation for over 24 hours.
- Primary outcome: death or new disability (≥10% increase in WHODAS 2.0) at six months post-ICU.
- Secondary outcomes included quality of life, cognition, and mental health at three and six months, with a significance level of 0.01.
Main Results:
- The primary outcome (death or new disability) occurred in 72.5% of PerCI patients versus 53.9% of controls (adjusted risk difference 10.70%).
- Mortality at six months was significantly higher in the PerCI group (30.2%) compared to controls (10.4%) (p<0.001).
- In survivors, new disability was observed in 50.5% of PerCI patients versus 32.2% in controls, with significant recovery noted between three and six months.
Conclusions:
- Patients with persistent critical illness experience a higher incidence of death or new disability at six months post-ICU.
- Significant recovery in functional outcomes was observed among PerCI survivors between three and six months.
- Further research should focus on interventions to improve long-term outcomes for PerCI patients.
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