Long term outcomes following critical care hospital admission: A prospective cohort study of UK biobank participants

Intensive care and emotional Long-term outcomes Recovery

Journal

The Lancet regional health. Europe
ISSN: 2666-7762
Titre abrégé: Lancet Reg Health Eur
Pays: England
ID NLM: 101777707

Informations de publication

Date de publication:
Jul 2021
Historique:
entrez: 22 7 2021
pubmed: 23 7 2021
medline: 23 7 2021
Statut: ppublish

Résumé

: This study aimed to understand the impact of a critical care admission on long-term outcomes, compared to other hospitalised patients without a critical care encounter. A secondary aim was to examine the interrelationship between emotional, physical, and social problems during recovery. : We utilised data from the UK Biobank, an on-going, prospective population-based cohort study. We employed propensity score matching to assess differences in outcomes between patients with a critical care encounter and patients admitted to the hospital (first admission to hospital available) without critical care. Structural equation modelling was used to analyse emotional, physical and social outcomes following critical illness and the relationships between these health domains. : Data from 1,618 patients were analysed. The median time to follow-up in the critical care cohort was 4427 days (IQR:788-6146) vs 4516 days (IQR: 811-6369) in the non-critical care, hospitalised cohort. Across the two time periods assessed (pre and post 2000), patients exposed to critical care were more likely to experience mental health issues such as depression ( This cohort study has demonstrated that survivors of critical illness have different psycho-social outcomes to matched patients, hospitalised without a critical care encounter. JM is funded by a THIS.Institute (University of Cambridge) Research Fellowship (PD-2019-02-16). AHL is part of the Social and Public Health Sciences Unit, funded by the Medical Research Council (MC_UU_12017/13) and the Scottish Government Chief Scientist Office (SPHSU13).

Sections du résumé

BACKGROUND BACKGROUND
: This study aimed to understand the impact of a critical care admission on long-term outcomes, compared to other hospitalised patients without a critical care encounter. A secondary aim was to examine the interrelationship between emotional, physical, and social problems during recovery.
METHODS METHODS
: We utilised data from the UK Biobank, an on-going, prospective population-based cohort study. We employed propensity score matching to assess differences in outcomes between patients with a critical care encounter and patients admitted to the hospital (first admission to hospital available) without critical care. Structural equation modelling was used to analyse emotional, physical and social outcomes following critical illness and the relationships between these health domains.
FINDINGS RESULTS
: Data from 1,618 patients were analysed. The median time to follow-up in the critical care cohort was 4427 days (IQR:788-6146) vs 4516 days (IQR: 811-6369) in the non-critical care, hospitalised cohort. Across the two time periods assessed (pre and post 2000), patients exposed to critical care were more likely to experience mental health issues such as depression (
INTERPRETATION CONCLUSIONS
This cohort study has demonstrated that survivors of critical illness have different psycho-social outcomes to matched patients, hospitalised without a critical care encounter.
FUNDING BACKGROUND
JM is funded by a THIS.Institute (University of Cambridge) Research Fellowship (PD-2019-02-16). AHL is part of the Social and Public Health Sciences Unit, funded by the Medical Research Council (MC_UU_12017/13) and the Scottish Government Chief Scientist Office (SPHSU13).

Identifiants

pubmed: 34291229
doi: 10.1016/j.lanepe.2021.100121
pii: S2666-7762(21)00098-3
pmc: PMC8278491
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100121

Subventions

Organisme : Medical Research Council
ID : MC_PC_17228
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00022/2
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12017/13
Pays : United Kingdom
Organisme : Chief Scientist Office
ID : SPHSU13
Pays : United Kingdom
Organisme : Chief Scientist Office
ID : SPHSU17
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_QA137853
Pays : United Kingdom

Informations de copyright

© 2021 The Authors.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to declare. This research was designed, conducted, analysed and interpreted by the authors entirely independently of the funding sources.

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Auteurs

Joanne McPeake (J)

Intensive Care Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.

Theodore J Iwashyna (TJ)

Centre for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, MI, United States of America.
Department of Internal Medicine, Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, Michigan, United States of America.

Philip Henderson (P)

School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom.

Alastair H Leyland (AH)

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.

Daniel Mackay (D)

Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.

Tara Quasim (T)

Intensive Care Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom.
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom.

Matthew Walters (M)

School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom.

Michael Harhay (M)

Department of Biostatistics, Epidemiology, and Informatics; and Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, United States.

Martin Shaw (M)

School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom.
Clinical Physics, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom.

Classifications MeSH