Abstract
BackgroundModern methods in intensive care medicine often enable the survival of older critically ill patients. The short-term outcomes for patients treated in intensive care units (ICUs), such as survival to hospital discharge, are well documented. However, relatively little is known about subsequent long-term outcomes. Pain, anxiety and agitation are important stress factors for many critically ill patients. There are very few studies concerned with pain, anxiety and agitation and the consequences in older critically ill patients. The overall aim of this study is to identify how an ICU stay influences an older person's experiences later in life. More specific, this study has the following objectives: (1) to explore the relationship between pain, anxiety and agitation during ICU stays and experiences of the same symptoms in later life; and (2) to explore the associations between pain, anxiety and agitation experienced during ICU stays and their effect on subsequent health-related quality of life, use of the health care system (readmissions, doctor visits, rehabilitation, medication use), living situation, and survival after discharge and at 6 and 12 months of follow-up.Methods/DesignA prospective, longitudinal study will be used for this study. A total of 150 older critically ill patients in the ICU will participate (ICU group). Pain, anxiety, agitation, morbidity, mortality, use of the health care system, and health-related quality of life will be measured at 3 intervals after a baseline assessment. Baseline measurements will be taken 48 hours after ICU admission and one week thereafter. Follow-up measurements will take place 6 months and 12 months after discharge from the ICU. To be able to interpret trends in scores on outcome variables in the ICU group, a comparison group of 150 participants, matched by age and gender, recruited from the Swiss population, will be interviewed at the same intervals as the ICU group.DiscussionLittle research has focused on long term consequences after ICU admission in older critically ill patients. The present study is specifically focussing on long term consequences of stress factors experienced during ICU admission.Trial RegistrationISRCTN52754370
Highlights
Modern methods in intensive care medicine often enable the survival of older critically ill patients
Little research has focused on long term consequences after intensive care units (ICUs) admission in older critically ill patients
The present study is focussing on long term consequences of stress factors experienced during ICU admission
Summary
Modern methods in intensive care medicine often enable the survival of older critically ill patients. Pain, anxiety, and agitation, and their consequences for long-term outcomes, have rarely been examined in older critically ill patients in the ICU [24,25,26]. In contrast to other studies [22,23], the present study examines the relationship between the ICU stay and post-hospital pain, anxiety and agitation in older critically ill patients, and addresses whether acute experiences in the ICU can cause more serious chronic conditions after discharge. This article describes a longitudinal study in which older critically ill patients are followed one year after their discharge from the hospital Under investigation were their pain experiences, levels of anxiety and agitation, health-related quality of life, and use of the health care system, in order to detect relationships between these main outcomes and their ICU experiences. Co-morbidities will be measured using the International Classification of Diseases (ICD), Version 10 [28]
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