Abstract 18115: A Multidisciplinary Approach to Critical Cardiac Illness Survivorship: Cardiac Intensive Care Unit Recovery Clinic

Abstract

Introduction: Cardiac intensive care unit (CICU) survivors have a high burden of morbidity and debility. Patients discharged from the CICU with a diagnosis of cardiogenic or septic shock, coma after cardiac arrest, or receive mechanical ventilation or mechanical circulatory support are referred by the CICU team to the Cardiac Intensive Care Unit Recovery Clinic (CICURC), a multidisciplinary clinic aimed at identifying barriers to return to function and optimizing medical and rehabilitation therapies. Aims: To define the cardiac profile and symptom burden of CICURC patients and compare outcomes to those referred but never attended. Methods: The medical records of sequential patients referred to the CICURC at our institution were retrospectively reviewed for clinical and outcome variables. Surveys were used to assess for cognitive, physical, or mental health impairment, findings of post-intensive care syndrome (PICS). Chi-squared test was performed to compare outcomes between groups. Results: From CICURC opening July 1, 2022, through May 27, 2023, 27 patients were referred, of whom 15 (56%) were seen in CICURC. The median age of patients seen in clinic was 61 years (IQR 47-74), 14 (93%) were male, 11 (73%) had an out-of-hospital cardiac arrest, 9 (60%) recovered from cardiogenic shock, of whom 5 (33%) were on mechanical circulatory support, and 12 received mechanical ventilation (80%). The median EF was 40% (IQR 25-50). From surveys, 5 patients screened positive for PICS (33%) and 6 were at risk for malnutrition (43%). Compared to those who did not attend clinic, only 1 (7%) CICURC attendee was readmitted within 30 days (vs. 3 [25%], p=0.18) and later died (vs. 4 [40%], p=0.04). Conclusions: CICU survivors have a high burden of disability after discharge. Multidisciplinary clinics focused on CICU recovery may reduce 30-day readmissions and mortality. Further research is needed on diagnosing PICS and therapies for recovery from critical cardiac illness.