New Physical, Mental, and Cognitive Problems 1-year Post-ICU

Half of the Intensive Care Unit (ICU) survivors suffer from new physical, mental and/or cognitive problems one year after ICU admission. This is evident from the large-scale MONITOR-IC study led by the Radboudumc. In this study the health status of ICU survivors is monitored up to five years after ICU admission using self-reported questionnaires. This includes problems like fatigue, reduced condition, and feelings of anxiety and depression.

In this study, physical problems, such as fatigue, reduced condition and stiffness in joints, were most frequently reported among the 2345 participating ICU patients. Some of the ICU survivors also struggle with mental problems, such as feelings of anxiety and depression, but also PTSD (post-traumatic stress disorder) symptoms. Over 12% have cognitive problems such as memory and attention problems. All these problems have an impact on the daily life of these patients. For example, about 40% experienced work-related problems due to these post ICU symptoms:  they are still on sick leave, work fewer hours, or have given up their job.

Distinct differences were found between different patient groups. For example, patients admitted to the ICU after urgent surgery are more likely to experience health problems one year after their admission, whereas patients admitted to the ICU after planned surgery are more likely to report that their health has improved during that time. This may be a result as a better preparation prior to the surgery, but also because their pre-existing problems, such as heart problems, have been resolved. 

Health before admission plays a major role

The study, in which patients from the Radboudumc, CWZ, Jeroen Bosch Hospital and Bernhoven hospitals were included, shows that ICU patients’ health situation prior to the ICU admission strongly associated with health problems one year after ICU admission. Project leaders Mark van den Boogaard and Marieke Zegers: "Patients who were already in poor health condition before admission have poorer outcomes. So, the healthier, the better your recovery". Men and patients with a higher education level have a lower risk of problems one year after admission.

MONITOR-IC follows patients for five years

This publication consisted of the first results of the MONITOR-IC study (www.monitor-ic.nl), a large-scale multicenter study conducted at the Bernhoven (Uden), Jeroen Bosch Hospital (Den Bosch), Amphia (Breda), Rijnstate (Arnhem), Maasziekenhuis (Boxmeer), Canisius Wilhelmina Hospital and the Radboudumc (both Nijmegen) hospitals. Researcher Wytske Geense will defend her PhD on these findings later this year. In the MONITOR-IC over 5000 ICU patients are now being followed up to five years after their ICU admission. For both planned and unplanned admissions, the health situation before admission is asked.

About the publication

Publication in American Journal of Respiratory and Critical Care Medicine: New Physical, Mental, and Cognitive Problems 1-year Post-ICU: A Prospective Multicenter Study - Wytske W. Geense, Marieke Zegers, Marco A. A. Peters, Esther Ewalds, Koen S. Simons, Hester Vermeulen, Johannes G van der Hoeven, and Mark van den Boogaard. DOI: https://doi.org/10.1164/rccm.202009-3381OC.

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