Post-Intensive Care Syndrome (PICS)
Conditions
Keywords
Post-Intensive Care Syndrome (PICS), High-dependency unit, functional outcome
Brief summary
Over the past two decades, the rapid advancement of critical care medicine has significantly reduced short-term mortality among critically ill patients. However, a growing number of intensive care unit (ICU) survivors experience persistent physical, cognitive, and psychological impairments after hospital discharge, a syndrome termed post-intensive care syndrome (PICS). Although PICS has gained increasing attention in recent years, existing studies still have multiple limitations. Given the continuously increasing number of ICU survivors in China and the marked heterogeneity in critical care delivery models across different regions and healthcare institutions, there is an urgent need for large-scale multicenter observational studies to systematically characterize the epidemiological features, multidimensional functional impairment profiles, and clinical impact of PICS in Chinese patients, thereby providing an evidence-based foundation for the development of a scientific post-ICU continuum of care.
Detailed description
This multi-center observational study aims to characterize the epidemiological profile and multidimensional functional impairments of Post-Intensive Care Syndrome (PICS) in ICU survivors across China. The study will enroll approximately 800 eligible participants from four participating high-dependency units (HDUs) between January 2018 and January 2026. Data on physical, cognitive, and psychological function will be collected using validated assessment tools including the MRC score, ICU Mobility Scale, CPAx, MMSE, S5Q, PHQ-9, GAD-7, PSQI, Barthel Index, and EQ-5D-5L. The primary outcomes include the incidence of PICS and comorbidity patterns across multiple functional domains. The secondary outcomes encompass functional status, quality of life, and risk factors for PICS.
Interventions
OTHERData Collection and Assessment
1. General clinical data collection: demographic characteristics, primary disease, duration of tracheostomy tube retention, duration of mechanical ventilation before transfer, and length of ICU stay before transfer; history of organ dysfunction; tube/catheter status; disease severity; nutritional status. 2. Physical function assessment: diaphragmatic excursion, diaphragm thickness, thickening fraction, PEF; Medical Research Council score for muscle strength, ICU Mobility Scale; comprehensive score: Chelsea Critical Care Physical Assessment Tool score. 3. Cognitive function assessment: Standardized Five Questions，Mini-Mental State Examination. 4. Psychological status assessment: Patient Health Questionnaire-9 for depression, Generalized Anxiety Disorder 7-item scale , Pittsburgh Sleep Quality Index, Brief Pain Inventory-9, Hospital Anxiety and Depression Scale for family caregivers. 5. Quality of life and functional capacity: Barthel Index, EQ-5D-5L.
Sponsors
Hongying Jiang, MD
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years * First admission to ICU, with ICU length of stay ≥ 48 hours before transfer to HDU * Complete the PICS assessment within 7 days after HDU admission * Complete clinical data available (demographics, ICU-related information) * Signed informed consent obtained from participants or legal guardians
Exclusion criteria
* Prior ICU admission * Terminal illness or estimated life expectancy \<6 months * Participants or family members refuse to complete questionnaires
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| MRC Sum Score for Muscle Strength | Collect data within 24 hours after admission to the HDU or within 24 hours before discharge from the ICU. | MRC (Medical Research Council) sum score assessing muscle strength. Total score ranges from 0 (complete quadriplegia) to 60 (normal bilateral muscle strength). Higher scores indicate better muscle strength. |
| ICU Mobility Scale Score | Collect data within 24 hours after admission to the HDU or within 24 hours before discharge from the ICU. | ICU Mobility Scale (IMS) assessing mobility level in ICU patients. Total score ranges from 0 (lying in bed, not active) to 10 (walking independently). Higher scores indicate better mobility. |
| Chelsea Critical Care Physical Assessment Tool Score | Collect data within 24 hours after admission to the HDU or within 24 hours before discharge from the ICU. | Chelsea Critical Care Physical Assessment Tool (CPAx) comprehensively evaluating physical function in ICU patients. Total score ranges from 0 to 50. Higher scores indicate better physical function. |
| Mini-Mental State Examination Score | Collect data within 24 hours after admission to the HDU or within 24 hours before discharge from the ICU. | Mini-Mental State Examination (MMSE) assessing cognitive function. Total score ranges from 0 to 30. Higher scores indicate better cognitive function. (Chinese validated version will be used.) |
| PHQ-9 Score for Depression | Collect data within 24 hours after admission to the HDU or within 24 hours before discharge from the ICU. | Patient Health Questionnaire-9 (PHQ-9) assessing severity of depressive symptoms. Total score ranges from 0 to 27 (0-4: none, 5-9: mild, 10-14: moderate, 15-19: moderately severe, 20-27: severe). Higher scores indicate worse depression. |
| GAD-7 Score for Anxiety | Collect data within 24 hours after admission to the HDU or within 24 hours before discharge from the ICU. | Generalized Anxiety Disorder 7-item scale (GAD-7) assessing severity of anxiety symptoms. Total score ranges from 0 to 21 (0-4: none, 5-9: mild, 10-14: moderate, 15-21: severe). Higher scores indicate worse anxiety. |
| Pittsburgh Sleep Quality Index Global Score | Collect data within 24 hours after admission to the HDU or within 24 hours before discharge from the ICU. | Pittsburgh Sleep Quality Index (PSQI) assessing sleep quality. Global score ranges from 0 to 21. Higher scores indicate worse sleep quality. |
| Brief Pain Inventory-9 Pain Severity Score | Collect data within 24 hours after admission to the HDU or within 24 hours before discharge from the ICU. | Brief Pain Inventory-9 (BPI-9) pain severity score. Total score ranges from 0 to 10. Higher scores indicate more severe pain. |
| Hospital Anxiety and Depression Scale Score for Family Caregivers | Collect data within 24 hours after admission to the HDU or within 24 hours before discharge from the ICU. | Hospital Anxiety and Depression Scale (HADS) assessing psychological status of family caregivers. Each subscale (anxiety and depression) ranges from 0 to 21. Higher scores indicate worse psychological distress. |
Countries
China
Contacts
CONTACTJingyi Ge
CONTACTHongying Jiang, MD
Outcome results
None listed