Health Equity and Critical Care Survivorship: Where Do We Go From Here?
Authors: Kelly M. Potter, Leslie P. Scheunemann, Timothy D. Girard
Journal: Annals of Internal Medicine (2022)

EditorialsMay 2022Health Equity and Critical Care Survivorship: Where Do We Go From Here?Kelly M. Potter, PhD, RN, CNE, Leslie P. Scheunemann, MD, MPH, Timothy D. Girard, MD, MSCIKelly M. Potter, PhD, RN, CNEThe Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, Leslie P. Scheunemann, MD, MPHDivision of Geriatric Medicine and Gerontology and Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, Timothy D. Girard, MD, MSCIThe Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PennsylvaniaAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-0726 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The large and growing population of patients currently struggling with postacute sequelae of COVID-19 (1), also known as long COVID, has focused a spotlight on a fact long recognized by survivors of critical illness—short-term recovery from a seemingly acute illness is often just the beginning of a much longer journey. Among the millions of patients who survive an acute life-threatening illness or injury each year, new or worsening deficits in physical (2), cognitive (3), and psychiatric function (4) are collectively known as post–intensive care syndrome (PICS), a disorder that affects up to 60% of patients whose acute illness required life-support ...References1. Lerner AM, Robinson DA, Yang L, et al. Toward understanding COVID-19 recovery: National Institutes of Health workshop on postacute COVID-19. Ann Intern Med. 2021;174:999-1003. [PMID: 33780290] doi:10.7326/M21-1043 LinkGoogle Scholar2. Herridge MS, Tansey CM, Matté A, et al; Canadian Critical Care Trials Group. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364:1293-304. [PMID: 21470008] doi:10.1056/NEJMoa1011802 CrossrefMedlineGoogle Scholar3. Pandharipande PP, Girard TD, Jackson JC, et al; BRAIN-ICU Study Investigators. Long-term cognitive impairment after critical illness. N Engl J Med. 2013;369:1306-16. [PMID: 24088092] doi:10.1056/NEJMoa1301372 CrossrefMedlineGoogle Scholar4. Jackson JC, Pandharipande PP, Girard TD, et al; Bringing to light the Risk Factors And Incidence of Neuropsychological dysfunction in ICU survivors (BRAIN-ICU) study investigators. Depression, post-traumatic stress disorder, and functional disability in survivors of critical illness in the BRAIN-ICU study: a longitudinal cohort study. Lancet Respir Med. 2014;2:369-79. [PMID: 24815803] doi:10.1016/S2213-2600(14)70051-7 CrossrefMedlineGoogle Scholar5. Marra A, Pandharipande PP, Girard TD, et al. Co-occurrence of post-intensive care syndrome problems among 406 survivors of critical illness. Crit Care Med. 2018;46:1393-1401. [PMID: 29787415] doi:10.1097/CCM.0000000000003218 CrossrefMedlineGoogle Scholar6. Kamdar BB, Sepulveda KA, Chong A, et al. Return to work and lost earnings after acute respiratory distress syndrome: a 5-year prospective, longitudinal study of long-term survivors. Thorax. 2018;73:125-133. [PMID: 28918401] doi:10.1136/thoraxjnl-2017-210217 CrossrefMedlineGoogle Scholar7. Brummel NE, Hughes CG, Thompson JL, et al. Inflammation and coagulation during critical illness and long-term cognitive impairment and disability. Am J Respir Crit Care Med. 2021;203:699-706. [PMID: 33030981] doi:10.1164/rccm.201912-2449OC CrossrefMedlineGoogle Scholar8. Brown SM, Wilson EL, Presson AP, et al; with the National Institutes of Health NHLBI ARDS Network. Understanding patient outcomes after acute respiratory distress syndrome: identifying subtypes of physical, cognitive and mental health outcomes. Thorax. 2017;72:1094-1103. [PMID: 28778920] doi:10.1136/thoraxjnl-2017-210337 CrossrefMedlineGoogle Scholar9. Jain S, Murphy TE, O'Leary JR, et al. Association between socioeconomic disadvantage and decline in function, cognition, and mental health after critical illness among older adults: a cohort study. Ann Intern Med. 2022;175:644-55. doi:10.7326/M21-3086 LinkGoogle Scholar10. Iwashyna TJ, Johnson AB, McPeake J, et al. The dirty dozen: common errors on discharging patients recovering from critical illness. Life in the Fast Lane. 3 November 2020. Accessed at https://litfl.com/the-dirty-dozen-common-errors-on-discharging-patients-recovering-from-critical-illness on 3 March 2022. Google Scholar11. Peach BC, Valenti M, Sole ML. A call for the World Health Organization to create International Classification of Disease diagnostic codes for post-intensive care syndrome in the age of COVID-19. World Med Health Policy. 2021. [PMID: 33821196] doi:10.1002/wmh3.401 CrossrefMedlineGoogle Scholar12. Roberts ET, McGarry BE, Glynn A. Cognition and take-up of the Medicare savings programs. JAMA Intern Med. 2020;180:1529-1531. [PMID: 33044503] doi:10.1001/jamainternmed.2020.2783 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Kelly M. Potter, PhD, RN, CNE; Leslie P. Scheunemann, MD, MPH; Timothy D. Girard, MD, MSCIAffiliations: The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PennsylvaniaDivision of Geriatric Medicine and Gerontology and Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PennsylvaniaDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-0726.Corresponding Author: Timothy D. Girard, MD, MSCI, 101 Keystone Building, 3520 Fifth Avenue, Pittsburgh, PA 15213; e-mail, timothy.girard@pitt.edu.This article was published at Annals.org on 8 March 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAssociation Between Socioeconomic Disadvantage and Decline in Function, Cognition, and Mental Health After Critical Illness Among Older Adults Snigdha Jain , Terrence E. Murphy , John R. O'Leary , Linda Leo-Summers , and Lauren E. Ferrante Metrics May 2022Volume 175, Issue 5Page: 749-750KeywordsHealth disparitiesHospitalizationsIntensive care unitsMedicareRacial and ethnic issuesSocioeconomic status ePublished: 8 March 2022 Issue Published: May 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...