MICU Recovery Clinic

Study Overview
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Brief Summary
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Summary: Emerging data demonstrate long-term morbidity and mortality in those who survive critical illness. However, there is no data regarding long-term follow-up for ICU survivors. The investigators have begun the implementation of an ICU recovery clinic. Rationale: ICU survivors are at high risk for functional, cognitive and psychiatric impairments. However, methods to mitigate these impairments and improve recovery are lacking. Special follow-up clinics for survivors of critical illness have been proposed and implemented to some degree, but are uncommon.

Detailed Description
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Objectives: To evaluate physical function, cognitive function, and overall functional status during recovery from critical illness. To evaluate anxiety, depression, and PTSD during recovery from critical illness. To evaluate resilience during recovery from critical illness. To evaluate healthcare utilization rates, morbidity, and mortality following critical illness. Added April 2016: To study the voice and swallowing function of patients following recovery from critical illness. Added April 2016: To study the pain of patients following recovery from critical illness. Intervention: A prospective observational study of all patients who attend our ICU recovery clinic. Methods: Patients will be identified for participation in our ICU Recovery Clinic during their admission to the Wake Forest Baptist Medical Center Medical Intensive Care Unit (MICU). They will be asked to return to the ICU recovery clinic within 1 month of hospital discharge. Structured clinic visits as standard of care will include medication reconciliation and evaluation by a pharmacist, along with an evaluation by a clinic physician to address acute medical issues and provide counselling. They will also undergo standardized testing to evaluate physical function, cognitive function, and psychiatric function. Added April 2016: They will also undergo a standardized evaluation of speech, swallow, and pain.

Official Title
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Evaluation of Outcomes Following Critical Illness Through a MICU Recovery Clinic

Conditions
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Critical Illness, Sepsis, Respiratory Failure, ARDS

Intervention / Treatment
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* Other: Questionnaires, Physical and Cognitive Function


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Wake Forest MICU Admission sepsis OR respiratory failure requiring >24 hrs of invasive mechanical ventilation previously functional Exclusion Criteria: - Active Malignancy
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 |
| --- | --- |
| ICU Survivors<br>ICU survivors will be seen in a MICU Recovery Clinic where Questionnaires, Physical and Cognitive Function assessments will be measured | Other: Questionnaires, Physical and Cognitive Function<br>* ICU survivors will be administered a battery of questionnaires. Measurements of physical and cognitive function will also be performed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical Function | as measured by the Short Performance Physical Battery | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical Function | Handgrip strength | 6 months | 
| Cognitive Function | Montreal Cognitive Assessment | 6 months | 
| Anxiety/ Depression Screening | Hospital Anxiety and Depression Scale | 6 months | 
| Post Traumatic Stress Disorder Screening | Impact of Events Scale- Revised | 6 months | 
| Functional Status | Activities of Daily Living and Instrumental Activities of Daily Living | 6 months | 
| Resilience | Connor-Davidson Resilience Scale- 10 | 6 months | 
| Quality of Life | Short-Form 36 | 6 months | 
| Hospital Readmissions |  | 6 months | 
| Mortality |  | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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recovery, ICU, clinic, survivor, physical function