Theodore J Iwashyna1, Carol L Hodgson2, David Pilcher2, Michael Bailey2, Rinaldo Bellomo2. 1. Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. tiwashyn@umich.edu. 2. Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Abstract
OBJECTIVE: To identify the characteristics of patients with "persistent critical illness" (PerCI), as perceived by Australian and New Zealand intensive care unit clinicians. Patients with PerCI were defined as those whose reason for being in the ICU was now more related to their ongoing critical illness than their original reason for admission to the ICU. DESIGN AND PARTICIPANTS: Using a web-based survey, we recruited clinicians affiliated with the Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group (CTG) who cared for adults. Clinicians included doctors, nurses, physiotherapists, dietitians, research managers and others. We used the ANZICS-CTG mailing list to email a single request for anonymous participation. RESULTS: A total of 101 eligible clinicians responded to our survey. PerCI was believed to develop after a median of 10 days (IQR, 7-14 days), and to be somewhat uncommon (occurring in 10% of all ICU patients [IQR, 5%-15%], and in 50% of all patients with a prolonged ICU length of stay [IQR, 20%-60%]). Ninety per cent of respondents thought that patients with PerCI required ongoing invasive mechanical ventilation, and the most common problems were thought to be respiratory insufficiency (68%), delirium (59%) and acquired neuromuscular disease (54%). Ten per cent of patients with PerCI were expected to be alive and well and at home 6 months after ICU discharge, with another 15% alive and at home but requiring significant help. The remainder were expected to die within 6 months or to need institutional care. CONCLUSION: Patients with PerCI appear to be an identifiable group of ICU patients, with definable characteristics, substantial stress associated with their care, and poor perceived long-term outcomes.
OBJECTIVE: To identify the characteristics of patients with "persistent critical illness" (PerCI), as perceived by Australian and New Zealand intensive care unit clinicians. Patients with PerCI were defined as those whose reason for being in the ICU was now more related to their ongoing critical illness than their original reason for admission to the ICU. DESIGN AND PARTICIPANTS: Using a web-based survey, we recruited clinicians affiliated with the Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group (CTG) who cared for adults. Clinicians included doctors, nurses, physiotherapists, dietitians, research managers and others. We used the ANZICS-CTG mailing list to email a single request for anonymous participation. RESULTS: A total of 101 eligible clinicians responded to our survey. PerCI was believed to develop after a median of 10 days (IQR, 7-14 days), and to be somewhat uncommon (occurring in 10% of all ICU patients [IQR, 5%-15%], and in 50% of all patients with a prolonged ICU length of stay [IQR, 20%-60%]). Ninety per cent of respondents thought that patients with PerCI required ongoing invasive mechanical ventilation, and the most common problems were thought to be respiratory insufficiency (68%), delirium (59%) and acquired neuromuscular disease (54%). Ten per cent of patients with PerCI were expected to be alive and well and at home 6 months after ICU discharge, with another 15% alive and at home but requiring significant help. The remainder were expected to die within 6 months or to need institutional care. CONCLUSION:Patients with PerCI appear to be an identifiable group of ICU patients, with definable characteristics, substantial stress associated with their care, and poor perceived long-term outcomes.
Authors: Carol L Hodgson; Alison E Turnbull; Theodore J Iwashyna; Ann Parker; Wesley Davis; Clifton O Bingham; Nicola R Watts; Simon Finfer; Dale M Needham Journal: Phys Ther Date: 2017-02-01
Authors: Sean M Bagshaw; Henry T Stelfox; Theodore J Iwashyna; Rinaldo Bellomo; Dan Zuege; Xioaming Wang Journal: Intensive Care Med Date: 2018-11-12 Impact factor: 17.440
Authors: Elizabeth M Viglianti; Sean M Bagshaw; Rinaldo Bellomo; Joanne McPeake; Xiao Qing Wang; Sarah Seelye; Theodore J Iwashyna Journal: Intensive Care Med Date: 2020-06-04 Impact factor: 17.440
Authors: Elizabeth M Viglianti; Rachel Kramer; Andrew J Admon; Michael W Sjoding; Carol L Hodgson; Rinaldo Bellomo; Theodore J Iwashyna Journal: J Crit Care Date: 2018-04-04 Impact factor: 3.425