Long-term Outcomes of Critical Illness Survivors

Study Overview
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Brief Summary
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The goal of this study is to assess the Long-term Outcomes of Critical Illness Survivors,including physical, psychological, and cognitive sequelae.

Detailed Description
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An increasing number of patients survive critical illness; however, the evidence reveals that over the same period the number of patients being sent to rehabilitation settings have tripled . For those who do survive, the latest data indicate that 50-70% of ICU survivors will suffer cognitive impairment and 60-80% of survivors will suffer functional impairment or ICU-acquired weakness (ICU-AW).Still,there is a lack valid data on the long-term impact on morbidity from prospective observational studies. Therefore, the investigators designed an observational cohort which cover a broader range of outcomes to quantify long-term physical, psychological, and cognitive impairment after intensive care unit (ICU).Intensive Care Unit patients survive from critical illness will be approached for study recruitment and participation.Survival rate,Quality of life,Cognitive impairments,Depression and anxiety,PTSD,Physical activity,Neuromuscular impairment will be assessed 3 or 6 months after ICU discharge.

Official Title
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Long-term Outcomes of Critical Illness Survivors：a Prospective Cohort Study

Conditions
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Intensive Care Units

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients aged >17 years Patients in intensive care unit(ICU) with at least one organ or system dysfunction,such as respiratory failure, cardiogenic shock,or septic shock. Exclusion Criteria: Refuse to participate Death before ICU discharge pre-existing cognitive impairment, malignant tumor

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Critical Illness Survivors<br>Those intensive care unit(ICU) patients who survive from critical illness. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival rate of ICU survivors | Critically ill patients discharged from ICU are defined as survivors | 3 or 6 months after ICU discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of life quality | Quality of Life assessed with help of The 36-item short from health survey(SF-36)questionnaire.The SF-36 has 8 scaled scores; the scores are weighted sums of the questions in each section. Scores range from 0-100. Lower scores = more disability, higher scores = less disability.The 8 sections are listed below:PF：Physical Functioning,RP：Role-Physical,BP：Bodily Pain,GH:General Health,VT：Vitality,SF：Social Functioning,RE：Role-Emotional,MH：Mental Health. | 3 or 6 months after ICU discharge | 
| Assessment in Physical dysfunction | Functional disabilities assessed with help of Barthel index of ADL(activities of daily living).10 variables are addressed. Range of summed total score: 0-100. higher values represent better outcome. | 3 or 6 months after ICU discharge | 
| Assessment in depression and anxiety | Depression and anxiety assessed with help of The Hospital Anxiety and Depression Scale(HADS).For Depression(D), 7 questions in total. Range of score for each question: 0-3. Total score summed: 0-21 ;For Anxiety(A): 7 questions in total. Range of score for each question: 0-3. Total score summed: 0-21 .For both D and A scales, higher scores represent worse outcome. | 3 or 6 months after ICU discharge | 
| Assessment in PTSD | Post-traumatic stress syndrome assessed with help of trauma screening questionnaire(TSQ).There are 10 questions in the TSQ. For each question, the answer is either YES or NO. More YES = worse outcome. At least 6 YES represents PTSD diagnosis. | 3 or 6 months after ICU discharge | 
| Assessment in Cognitive impairments | Cognitive impairments assessed with help of mini-mental state examination(MMSE).The MMSE has 5 scaled scores; the scores are weighted sums of the questions in each section. The 5 sections and their range of score are listed below:Orientation 0-10;Registration 0-3;Attention and calculation 0-5;Recall 0-3;Language 0-9.Total score range from 0-30. Lower scores = more disability, higher scores = less disability. | 3 or 6 months after ICU discharge | 
| Patients' care and support needs;social and economical consequences | Patients' information of specific needs and supports and social or economical impact post ICU. | 3 or 6 months after ICU discharge | 
| Neuromuscular impairment | Neuromuscular impairment will be assessed by electromyography/nerve conduction study | 3 or 6 months after ICU discharge |