The following is a summary of “Two-year prospective cohort of intensive care survivors enrolled on a digitally enabled recovery pathway focussed on individualised recovery goal attainment,” published in the June 2024 issue of Critical Care by Rose, et al.
Survivors of ICU often face physical, mental, and cognitive challenges after discharge, with limited support available, prompting the creation of a digital ICU recovery pathway for goal-setting and improved care.
Researchers conducted a prospective study exploring recovery barriers and challenges, recovery goals set and achieved, self-reported patient outcomes, and healthcare costs of patients enrolled on a 12-week digital ICU recovery pathway after hospital discharge.
They analyzed a 90-bed tertiary critical care service (June 2021 to May 2023). Adults ventilated for ≥3 days who could participate in recovery activities were enrolled. Baseline recovery challenges and set recovery goals, tracking achievement over 12 weeks, were identified. Patient-reported outcomes were collected at 2–4, 12–14, and 26–28 weeks, with healthcare utilization data gathered monthly for 28 weeks.
The results showed 105 participants and 35% of patients were eligible. Common rehabilitation challenges included standing balance (60%), walking indoors (56%), and abilities for washing (64%) and dressing (47%). Of 522 home recovery goals, 63% were achieved weekly, 48% monthly, and 38% were aspirational. Most goals focused on self-care, such as mobility outside the home (91 goals, 55% achieved) and inside (45 goals, 47% achieved), as well as community access (65 goals, 48% achieved). Nottingham Extended Activities of Daily Living Scale scores improved from time points 1 to 2 (median IQR: 15 [7, 19] vs. 19 [15, 21], P=0.01). Total healthcare costs amounted to £240,017 (median IQR cost per patient: £784 [£125, £4419]).
Investigators found that despite moderate healthcare costs, patients still had functional limitations, difficulty meeting recovery goals, and limited improvement in self-reported well-being, highlighting a need for more rehabilitation support after discharge.
Source: australiancriticalcare.com/article/S1036-7314(24)00093-6/fulltext#%20