Critical Illness
Conditions
Keywords
persistent critical illness, chronic critical illness, prolonged intensive care, weaning from mechanical ventilation, decannulation, multidisciplinary team, intensive care rehabilitation
Brief summary
This prospective observational study aims to describe the outcome for patients with persistent or chronic critical illness treated at Remeo, a clinic specialized for patients in need of prolonged intensive care and intensive care rehabilitation in Sweden. Patients' disease characteristics and the treatment in multidisciplinary patient centered teams for intensive care, weaning from mechanical ventilation and simultaneous rehabilitation will be described. Patients will be followed one year after discharge to document health related quality of life, physical function, frailty, mental illness and used health care resources.
Interventions
None listed
Sponsors
Karolinska Institutet
Remeo AB
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Admission to unit (Remeo, Stockholm, Sweden) Treated for prolonged critical illness
Exclusion criteria
Treated less than 48 hours at unit (Remeo, Stockholm, Sweden)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mortality during 12 months follow-up after discharge | Assessed 12 months after discharge | Mortality during 12 months follow-up after discharge |
| Independence in activities of daily living assessed by Katz Index of Independence in Activities of Daily Living (Katz ADL) | At admission to unit | Katz ADL (scale 0-6, higher value better) |
| In-patient mortality and mortality | Assessed immediately after discharge from unit | Mortality during care at unit |
| Health related quality of Life assessed by EuroQoL 5-dimension 5-level (EQ-5D-5L) | 3 months after discharge from unit | EQ-5D-5L questionnaire |
| Health related quality of Life assessed by the Rand 36-Item Health Survey (RAND36) | 3 months after discharge from unit | RAND36 (scale 0-100, higher value better) questionnaire |
| Change in mechanical ventilation status | Assessed at admittance and immediately after discharge from unit | Time (Days) from admittance to unit until weaned from mechanical ventilation |
| Change in tracheostomy status | Assessed at admittance and immediately after discharge from unit | Time (Days) from admittance to unit until decannulation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Inflammatory status relative to outcome | Through study completion, an average of 14 months | HMGB1 and routine inflammation markers' effect on outcome measures |
| Physical status as assessed by the Chelsea Critical Care Physical Assessment tool (CPAx). | At admission to unit | CPAx performed by a physiotherapist (scale 0-50 Points, higher value indicate better outcome) |
| Symptoms of depression as assessed by the Patient Health Questionnaire-9 (PHQ-9) | 3 months after discharge from unit | PHQ-9, a patient related outcome questionnaire, scale 0-27, higher value indicating more severe symptoms |
| Symptoms of generalized anxiety as assessed by the General anxiety disorder 7 (GAD-7) questionnaire | 3 months after discharge from unit | GAD-7, a patient related outcome questionnaire, scale 0-21, higher value indicating more severe symptoms |
| Frailty as assessed by the Clinical frailty scale (CFS) | At admission to unit | The Clinical frailty scale has 9 levels from very fit to terminally ill (1-9, lower value indicate better outcome) |
| Physical status as assessed by the 6 minutes walk test | At admission to unit | The 6 min walk test evaluated by a physiotherapist (longer distance (meters) better outcome) |
| Cognitive status as assessed by the Montreal cognitive assessment (MoCa) test | At admission to unit | Performed by an occupational therapist. The MoCa test score scale is 0-30 Points, higher value indicate better outcome |
| Swallowing function and possibility of oral intake | At admission to unit | Using the Functional oral intake scale (FOIS) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Antibiotic use | From admittance until discharge | Days with antibiotic treatment during stay at unit. |
| Number and type of Health care Contacts after discharge | Assessed 12 months after discharge from unit | Number of Contacts with primary care, emergency room and hospital admissions after discharge |
| Need of support after discharge for patients discharged home | Immediately after discharge from unit | For patients discharged home, the type of homecare needed (if any) |
| Discharge destination | Immediately after discharge from unit | The location the patient was discharged to; home, rehabilitation unit, acute care hospital, nursing home, palliative care unit |
| Antibiotic use 12 months after discharge | From discharge until12 month thereafter | Number of infections treated with antibiotics after discharge |
Countries
Sweden
Contacts
Primary ContactEva Sundman, MD, PhD
Backup ContactAnna Cedborg, MD, PhD
Outcome results
None listed