New Physical, Mental, and Cognitive Problems 1-year Post-ICU: A Prospective Multicenter Study.

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 co-occurrence of new physical, mental, and cognitive problems among ICU survivors one year after ICU admission, their impact on daily functioning and risk factors associated with one-year outcomes. METHODS Prospective multicenter cohort study, including ICU patients ≥16 years, admitted for ≥12 hours between July 2016-June 2019. Patients, or proxies, rated their health status before and one-year post-ICU using questionnaires. Measurements and mean 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 4793 patients included, 2345 completed the questionnaires both pre- and one-year post-ICU. New physical, mental, and/or cognitive problems one-year post-ICU were experienced by 58% of the medical, 64% of the urgent surgical, 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.