New Physical, Mental, and Cognitive Problems 1 Year after ICU Admission: A Prospective Multicenter Study

Am J Respir Crit Care Med. 2021 Jun 15;203(12):1512-1521. doi: 10.1164/rccm.202009-3381OC.


Rationale: Comprehensive studies addressing the incidence of physical, mental, and cognitive problems after ICU admission are lacking. With an increasing number of ICU survivors, an improved understanding of post-ICU problems is necessary. Objectives: To determine the occurrence and cooccurrence of new physical, mental, and cognitive problems among ICU survivors 1 year after ICU admission, their impact on daily functioning, and risk factors associated with 1-year outcomes. Methods: Prospective multicenter cohort study, including ICU patients ⩾16 years of age, admitted for ⩾12 hours between July 2016 and June 2019. Patients, or proxies, rated their health status before and 1 year after ICU admission using questionnaires. Measurements and Main Results: Validated questionnaires were used to measure frailty, fatigue, new physical symptoms, anxiety and depression, post-traumatic stress disorder, cognitive impairment, and quality of life. Of the 4,793 patients included, 2,345 completed the questionnaires both before and 1 year after ICU admission. New physical, mental, and/or cognitive problems 1 year after ICU admission were experienced by 58% of the medical patients, 64% of the urgent surgical patients, and 43% of the elective surgical patients. Urgent surgical patients experienced a significant deterioration in their physical and mental functioning, whereas elective surgical patients experienced a significant improvement. Medical patients experienced an increase in symptoms of depression. A significant decline in cognitive functioning was experienced by all types of patients. Pre-ICU health status was strongly associated with post-ICU health problems. Conclusions: Overall, 50% of ICU survivors suffer from new physical, mental, and/or cognitive problems. An improved insight into the specific health problems of ICU survivors would enable more personalized post-ICU care.

Keywords: critical care; critical illness; outcome assessment; patient-reported outcome measures; quality of life.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / etiology*
  • Anxiety Disorders / therapy
  • Cognitive Dysfunction / psychology*
  • Cohort Studies
  • Critical Care / psychology*
  • Critical Illness / psychology
  • Critical Illness / therapy
  • Depressive Disorder / etiology*
  • Depressive Disorder / therapy
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life / psychology*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress Disorders, Post-Traumatic / therapy
  • Surveys and Questionnaires
  • Survivors / psychology*
  • Young Adult