Two-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19
Abstract Background Post-intensive care syndrome (PICS) affects the quality of life (QOL) of survivors of critical illness. Although PICS persists for a long time, the longitudinal changes in each component and their interrelationships over time both remain unclear. This multicenter prospective stud...
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2025-02-01
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| author | Junji Hatakeyama Kensuke Nakamura Shigeaki Inoue Keibun Liu Kazuma Yamakawa Takeshi Nishida Shinichiro Ohshimo Satoru Hashimoto Naoki Kanda Shotaro Aso Shinya Suganuma Shuhei Maruyama Yoshitaka Ogata Akira Takasu Daisuke Kawakami Hiroaki Shimizu Katsura Hayakawa Takeshi Yoshida Taku Oshima Tatsuya Fuchigami Hironori Yawata Kyoji Oe Akira Kawauchi Hidehiro Yamagata Masahiro Harada Yuichi Sato Tomoyuki Nakamura Kei Sugiki Takahiro Hakozaki Satoru Beppu Masaki Anraku Noboru Kato Tomomi Iwashita Hiroshi Kamijo Yuichiro Kitagawa Michio Nagashima Hirona Nishimaki Kentaro Tokuda Osamu Nishida |
| author_facet | Junji Hatakeyama Kensuke Nakamura Shigeaki Inoue Keibun Liu Kazuma Yamakawa Takeshi Nishida Shinichiro Ohshimo Satoru Hashimoto Naoki Kanda Shotaro Aso Shinya Suganuma Shuhei Maruyama Yoshitaka Ogata Akira Takasu Daisuke Kawakami Hiroaki Shimizu Katsura Hayakawa Takeshi Yoshida Taku Oshima Tatsuya Fuchigami Hironori Yawata Kyoji Oe Akira Kawauchi Hidehiro Yamagata Masahiro Harada Yuichi Sato Tomoyuki Nakamura Kei Sugiki Takahiro Hakozaki Satoru Beppu Masaki Anraku Noboru Kato Tomomi Iwashita Hiroshi Kamijo Yuichiro Kitagawa Michio Nagashima Hirona Nishimaki Kentaro Tokuda Osamu Nishida |
| author_sort | Junji Hatakeyama |
| collection | DOAJ |
| description | Abstract Background Post-intensive care syndrome (PICS) affects the quality of life (QOL) of survivors of critical illness. Although PICS persists for a long time, the longitudinal changes in each component and their interrelationships over time both remain unclear. This multicenter prospective study investigated the 2-year trajectory of PICS and its components as well as factors contributing to deterioration or recovery in mechanically ventilated patients with coronavirus disease 2019 (COVID-19), and also attempted to identify possible countermeasures. Methods Patients who survived COVID-19 requiring mechanical ventilation completed questionnaires on the Barthel index, Short-Memory Questionnaire, Hospital Anxiety and Depression Scale, and EuroQol 5 dimensions 5-level every six months over a two-year period. Scores were weighted to account for dropouts, and the trajectory of each functional impairment was evaluated with alluvial diagrams. The prevalence of PICS and factors impairing or restoring function were examined using generalized estimating equations considering trajectories. Results Among 334 patients, PICS prevalence rates in the four completed questionnaires were 72.1, 78.5, 77.6, and 82.0%, with cognitive impairment being the most common and lower QOL being noted when multiple impairments coexisted. Physical function and QOL indicated that many patients exhibited consistent trends of either recovery or deterioration. In contrast, cognitive function and mental health revealed considerable variability, with many patients showing fluctuating ratings in the later surveys. Delirium was associated with worse physical and mental health and poor QOL, while prolonged ventilation was associated with poor QOL. Living with family was associated with the recovery of all functions and QOL, while extracorporeal membrane oxygenation (ECMO) was associated with the recovery of cognitive function and mental health. Conclusions Critically ill patients had PICS for a long period and followed different trajectories for each impairment component. Based on trajectories, known PICS risk factors such as prolonged ventilation and delirium were associated with impaired recovery, while ECMO and the presence of family were associated with recovery from PICS. In critically ill COVID-19 patients, delirium management and family interventions may play an important role in promoting recovery from PICS. Trial registration number: UMIN000041276, August 01, 2020. |
| format | Article |
| id | doaj-art-c263b1acf30e41508ec462def8a61746 |
| institution | Kabale University |
| issn | 2052-0492 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | Journal of Intensive Care |
| spelling | doaj-art-c263b1acf30e41508ec462def8a617462025-02-09T12:14:58ZengBMCJournal of Intensive Care2052-04922025-02-0113111310.1186/s40560-025-00777-zTwo-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19Junji Hatakeyama0Kensuke Nakamura1Shigeaki Inoue2Keibun Liu3Kazuma Yamakawa4Takeshi Nishida5Shinichiro Ohshimo6Satoru Hashimoto7Naoki Kanda8Shotaro Aso9Shinya Suganuma10Shuhei Maruyama11Yoshitaka Ogata12Akira Takasu13Daisuke Kawakami14Hiroaki Shimizu15Katsura Hayakawa16Takeshi Yoshida17Taku Oshima18Tatsuya Fuchigami19Hironori Yawata20Kyoji Oe21Akira Kawauchi22Hidehiro Yamagata23Masahiro Harada24Yuichi Sato25Tomoyuki Nakamura26Kei Sugiki27Takahiro Hakozaki28Satoru Beppu29Masaki Anraku30Noboru Kato31Tomomi Iwashita32Hiroshi Kamijo33Yuichiro Kitagawa34Michio Nagashima35Hirona Nishimaki36Kentaro Tokuda37Osamu Nishida38Department of Emergency and Critical Care Medicine, National Hospital Organization Tokyo Medical CenterDepartment of Critical Care Medicine, Yokohama City University School of MedicineDepartment of Emergency and Critical Care Medicine, Wakayama Medical UniversityICU Collaboration Network (ICON)Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical UniversityDivision of Trauma and Surgical Critical Care, Osaka General Medical CenterDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Intensive Care Medicine, Kyoto Prefectural University of MedicineDivision of General Internal Medicine, Jichi Medical University HospitalDepartment of Health Services Research, Graduate School of Medicine, The University of TokyoDepartment of Critical Care Medicine, Yokohama City University School of MedicineDepartment of Emergency and Critical Care Medicine, Kansai Medical University Medical CenterDepartment of Critical Care Medicine, Yao Tokushukai General HospitalDepartment of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical UniversityDepartment of Anesthesia and Critical Care, Kobe City Medical Center General HospitalAcute Care Medical Center, Hyogo Prefectural Kakogawa Medical CenterDepartment of Emergency and Critical Care Medicine, Saitama Red Cross HospitalDepartment of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of MedicineDepartment of Emergency and Critical Care Medicine, Chiba University Graduate School of MedicineDepartment of Anesthesiology and Intensive Care Medicine, University of the Ryukyus HospitalDepartment of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daiichi HospitalDepartment of Intensive Care Medicine, Asahi General HospitalJapanese Red Cross Maebashi Hospital, Department of Critical Care and Emergency MedicineAdvanced Emergency and Critical Care Center, Yokohama City University Medical CenterDepartment of Emergency and Critical Care, National Hospital Organization Kumamoto Medical CenterCritical Care and Emergency Center, Metropolitan Tama General Medical CenterDepartment of Anesthesiology and Critical Care Medicine, Fujita Health University School of MedicineDepartment of Intensive Care Medicine, Yokohama City Minato Red Cross HospitalDepartment of Anesthesiology, Fukushima Medical UniversityDepartment of Emergency & Critical Care Medicine, National Hospital Organization Kyoto Medical CenterDepartment of Thoracic Surgery, Tokyo Metropolitan Institute for Geriatrics and GerontologyDepartment of Emergency and Critical Care Medicine, Yodogawa Christian HospitalDepartment of Emergency and Critical Care Center, Nagano Red Cross HospitalIntensive Care Unit, Shinshu University HospitalEmergency and Disaster Medicine, Gifu University School of Medicine Graduate School of MedicineDepartment of Intensive Care Medicine, Tokyo Medical and Dental UniversityDepartment of Anesthesiology, Tohoku University HospitalIntensive Care Unit, Kyushu University HospitalDepartment of Anesthesiology and Critical Care Medicine, Fujita Health University School of MedicineAbstract Background Post-intensive care syndrome (PICS) affects the quality of life (QOL) of survivors of critical illness. Although PICS persists for a long time, the longitudinal changes in each component and their interrelationships over time both remain unclear. This multicenter prospective study investigated the 2-year trajectory of PICS and its components as well as factors contributing to deterioration or recovery in mechanically ventilated patients with coronavirus disease 2019 (COVID-19), and also attempted to identify possible countermeasures. Methods Patients who survived COVID-19 requiring mechanical ventilation completed questionnaires on the Barthel index, Short-Memory Questionnaire, Hospital Anxiety and Depression Scale, and EuroQol 5 dimensions 5-level every six months over a two-year period. Scores were weighted to account for dropouts, and the trajectory of each functional impairment was evaluated with alluvial diagrams. The prevalence of PICS and factors impairing or restoring function were examined using generalized estimating equations considering trajectories. Results Among 334 patients, PICS prevalence rates in the four completed questionnaires were 72.1, 78.5, 77.6, and 82.0%, with cognitive impairment being the most common and lower QOL being noted when multiple impairments coexisted. Physical function and QOL indicated that many patients exhibited consistent trends of either recovery or deterioration. In contrast, cognitive function and mental health revealed considerable variability, with many patients showing fluctuating ratings in the later surveys. Delirium was associated with worse physical and mental health and poor QOL, while prolonged ventilation was associated with poor QOL. Living with family was associated with the recovery of all functions and QOL, while extracorporeal membrane oxygenation (ECMO) was associated with the recovery of cognitive function and mental health. Conclusions Critically ill patients had PICS for a long period and followed different trajectories for each impairment component. Based on trajectories, known PICS risk factors such as prolonged ventilation and delirium were associated with impaired recovery, while ECMO and the presence of family were associated with recovery from PICS. In critically ill COVID-19 patients, delirium management and family interventions may play an important role in promoting recovery from PICS. Trial registration number: UMIN000041276, August 01, 2020.https://doi.org/10.1186/s40560-025-00777-zCOVID-19Post-intensive care syndromeTrajectoryFunctionQuality of lifeECMO |
| spellingShingle | Junji Hatakeyama Kensuke Nakamura Shigeaki Inoue Keibun Liu Kazuma Yamakawa Takeshi Nishida Shinichiro Ohshimo Satoru Hashimoto Naoki Kanda Shotaro Aso Shinya Suganuma Shuhei Maruyama Yoshitaka Ogata Akira Takasu Daisuke Kawakami Hiroaki Shimizu Katsura Hayakawa Takeshi Yoshida Taku Oshima Tatsuya Fuchigami Hironori Yawata Kyoji Oe Akira Kawauchi Hidehiro Yamagata Masahiro Harada Yuichi Sato Tomoyuki Nakamura Kei Sugiki Takahiro Hakozaki Satoru Beppu Masaki Anraku Noboru Kato Tomomi Iwashita Hiroshi Kamijo Yuichiro Kitagawa Michio Nagashima Hirona Nishimaki Kentaro Tokuda Osamu Nishida Two-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19 Journal of Intensive Care COVID-19 Post-intensive care syndrome Trajectory Function Quality of life ECMO |
| title | Two-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19 |
| title_full | Two-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19 |
| title_fullStr | Two-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19 |
| title_full_unstemmed | Two-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19 |
| title_short | Two-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19 |
| title_sort | two year trajectory of functional recovery and quality of life in post intensive care syndrome a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease 19 |
| topic | COVID-19 Post-intensive care syndrome Trajectory Function Quality of life ECMO |
| url | https://doi.org/10.1186/s40560-025-00777-z |
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