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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.
Objectives:
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ICU Survivors | ICU survivors will be seen in a MICU Recovery Clinic where Questionnaires, Physical and Cognitive Function assessments will be measured |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Questionnaires, Physical and Cognitive Function | Other | ICU survivors will be administered a battery of questionnaires. Measurements of physical and cognitive function will also be performed. |
| Measure | Description | Time Frame |
|---|---|---|
| Physical Function | as measured by the Short Performance Physical Battery | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Physical Function | Handgrip strength | 6 months |
| Cognitive Function | Montreal Cognitive Assessment | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Swallow Function | EAT 10 Questionnaire | 6 months |
| Speech | Voice Analysis | 6 months |
Inclusion Criteria: Wake Forest MICU Admission
Exclusion Criteria:
- Active Malignancy
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Wake Forest MICU Survivors
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| Name | Affiliation | Role |
|---|---|---|
| D. Clark Files, MD | Wake Forest University Health Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Wake Forest Baptist Medical Center | Winston-Salem | North Carolina | 27157 | United States |
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| D018805 | Sepsis |
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| D012149 | Restraint, Physical |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
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| 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 |
| Pain |
Brief Pain Inventory, modified version of the modified musculoskeletal questionnaire |
| 6 months |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
| D032763 | Behavior Control |
| D013812 | Therapeutics |
| D007103 | Immobilization |