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Problems following discharge after intensive care

K Daffurn, G F Bishop, K M Hillman

    Intensive & Critical Care Nursing
    |December 1, 1994
    PubMed
    Summary
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    Patients discharged from intensive care units (ICUs) often experience mild to moderate physical and psychosocial sequelae, including pain and mood disturbances, three months post-discharge. Many patients require further assessment and some have no recollection of their ICU stay.

    Area of Science:

    • Critical Care Medicine
    • Post-Intensive Care Syndrome
    • Patient Recovery Studies

    Background:

    • Intensive care units (ICUs) are common in acute care hospitals.
    • Long-term outcomes of ICU patients (mortality, function, quality of life) are studied.
    • Limited data exists on the immediate recovery period after ICU discharge.

    Purpose of the Study:

    • To identify and describe the sequelae experienced by patients three months after ICU discharge.
    • To understand the physical and psychosocial recovery trajectory post-ICU.

    Main Methods:

    • Prospective study conducted over six months in 1991 at a Sydney university teaching hospital.
    • Inclusion criteria: 54 patients with ICU length of stay (LOS) > 48 hours.
    • Data collection via outpatient clinic interviews, including pre-admission, admission details, treatments, complications, general health, social/employment status, functional status, referrals, and ICU memory.

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    Main Results:

    • Most patients approached near-normal general health but reported mild to moderate physical and psychosocial sequelae.
    • Predominant complaints included pain, sleep difficulties, tiredness, and breathlessness.
    • Over one-third experienced depression, irritability, or loneliness; more than half required further referrals. 34% had no ICU memory; 29.6% reported unpleasant memories.

    Conclusions:

    • Patients exhibit significant physical and psychosocial sequelae three months post-ICU discharge, impacting their recovery.
    • While not always incapacitating, these sequelae necessitate attention and potential interventions.
    • Memory impairment and psychological distress are notable outcomes for a substantial proportion of former ICU patients.