JMIR Publications

ABSTRACT

Background:

‘Post Intensive Care Syndrome’ (PICS) was defined by the Society of Critical Care Medicine in 2012 with subsequent international research highlighting the poor long-term outcomes, reduced quality of life, and ongoing impairments, activity limitations, and participation restrictions for survivors of critical illness. However, to date, there has been no published research about long-term outcomes for New Zealand survivors of critical illness.

Objective:

This mixed methods study will be the first to explore long-term outcomes after critical illness in New Zealand. It will also be done in the context of the global COVID pandemic. The primary objectives are to describe and quantify symptoms and disability in survivors of critical illness, to explore possible risk factors for their development, and to identify longer-term unmet needs for those who survive for a year.

Methods:

This will be a mixed methods study. There will be a prospective cohort study of 100 critically ill patients followed up one, six- and 12-months after hospital discharge. The primary outcome for the cohort study will be disability assessed with the World Health Organization’s Disability Assessment Scale: WHODAS 2.0. Secondary outcomes will focus on mental health using the Hospital Anxiety and Depression scale (HADS) and the Impact of Events Scale-revised (IES-r), cognitive function using the Montreal Cognitive Assessment (MOCA- blind), and Health related Quality of Life by the EQ-5D-5L. A second element of the study will use qualitative grounded theory methods to explore patients’ experiences of recovery, highlight their unmet needs and develop a model of barriers and facilitators to coping. This will use a sample from the main cohort with interviews conducted six months after discharge.

Results:

This study has received full ethics approval from the New Zealand Northern A Health and Disability Ethics Committee on the 16/8/21 (21/NTA/107) and has been registered with ANZCTR on 5/10/21 (12621001335886). SPLIT ENZ is due to start recruitment in early 2022 and will continue recruitment for up to two years aiming to enroll approximately 125 patients. Data collection is estimated to be completed by 2024–20255 and will be published once all data is available for reporting.

Conclusions:

Although International research identifies the prevalence of PICS and the extent of disability in survivors of critical illness there is no published research in New Zealand. Research in this field is particularly pressing in the context of COVID, an illness which may include PICS in its sequelae. To understand the extent of disability and the survival journey in New Zealand, would be of benefit not only to patients and families making sense of their recovery, but to clinicians and health care workers wanting to understand how best to support these patients once they have left hospital. Clinical Trial: Ethics ID: 21/NTA/107. Australia and New Zealand Clinical trials registration (ANZCTR) no: 1262100133588