Discrepancy between Functional Outcomes and Perceived Health Post-Intensive Care Unit: A Prospective Cohort Study

<b>Rationale:</b> Despite functional impairments, intensive care unit (ICU) survivors can perceive their quality of life as acceptable. <b>Objectives:</b> To investigate discrepancies between calculated health, based on self-reported physical, mental, and cognitive functioning and perceived health, 1 year after ICU admission. <b>Methods:</b> Data from an ongoing prospective multicenter cohort study, MONITOR-IC, were used. Patient-reported physical, mental, and cognitive functioning and perceived health (EuroQol visual analog scale; range, 0-100) 1 year post-ICU of patients admitted to 1 of 11 participating ICUs between July 2016 and September 2021 were analyzed. The relationship between functional outcomes and perceived health was modeled using linear regression. Calculated health for each patient was estimated using this model and compared with patients' perceived health, the difference reflecting a discrepancy. On the basis of a minimal clinically important difference of 8 points, three groups were defined: patients who rated their health better than calculated (positive discrepancy), patients who rated their health worse than calculated (negative discrepancy), and patients whose perceived health was concordant with their calculated health. <b>Results:</b> A total of 2,545 patients were analyzed, of whom 45.0% (<i>n</i> = 1,146) showed a discrepancy between calculated and perceived health. Patients with a negative discrepancy rated their health significantly lower (median, 50; interquartile range, 36-66) than patients with a positive discrepancy (median, 84; interquartile range, 75-90). Importantly, there were no significant differences in physical, mental, and cognitive functioning between patients with a negative versus positive discrepancy. Patients with a negative discrepancy had a higher education level and were more often unemployed. <b>Conclusions:</b> One year post-ICU, almost half of ICU survivors showed a discrepancy between calculated health and perceived health.

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Publication Details

Journal
Annals of the American Thoracic Society
Published
2024-10-23
DOI
https://doi.org/10.1513/annalsats.202405-564oc
Citations
5
Primary Topic
Intensive Care Unit Cognitive Disorders
Type
article
Field-Weighted Citation Impact
2.11

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article

Discrepancy between Functional Outcomes and Perceived Health Post-Intensive Care Unit: A Prospective Cohort Study

Koen S. Simons, Margaretha C. E. van der Woude, Inge Janssen, Thijs C.D. Rettig et al.
5 citations
Annals of the American Thoracic Society
Intensive Care Unit Cognitive Disorders
2.11
article

Discrepancy between Functional Outcomes and Perceived Health Post-Intensive Care Unit: A Prospective Cohort Study

Koen S. Simons, Margaretha C. E. van der Woude, Inge Janssen, Thijs C.D. Rettig, Crétien Jacobs, Johannes G. van der Hoeven, Stijn Corsten, Esther Ewalds, Lucy L. Porter, Brigitte Westerhof, Alison E. Turnbull, Marieke Zegers, Susanne van Santen, Mark van den Boogaard, Monika C. Kerckhoffs
article en
5 citations

Abstract

<b>Rationale:</b> Despite functional impairments, intensive care unit (ICU) survivors can perceive their quality of life as acceptable. <b>Objectives:</b> To investigate discrepancies between calculated health, based on self-reported physical, mental, and cognitive functioning and perceived health, 1 year after ICU admission. <b>Methods:</b> Data from an ongoing prospective multicenter cohort study, MONITOR-IC, were used. Patient-reported physical, mental, and cognitive functioning and perceived health (EuroQol visual analog scale; range, 0-100) 1 year post-ICU of patients admitted to 1 of 11 participating ICUs between July 2016 and September 2021 were analyzed. The relationship between functional outcomes and perceived health was modeled using linear regression. Calculated health for each patient was estimated using this model and compared with patients' perceived health, the difference reflecting a discrepancy. On the basis of a minimal clinically important difference of 8 points, three groups were defined: patients who rated their health better than calculated (positive discrepancy), patients who rated their health worse than calculated (negative discrepancy), and patients whose perceived health was concordant with their calculated health. <b>Results:</b> A total of 2,545 patients were analyzed, of whom 45.0% (<i>n</i> = 1,146) showed a discrepancy between calculated and perceived health. Patients with a negative discrepancy rated their health significantly lower (median, 50; interquartile range, 36-66) than patients with a positive discrepancy (median, 84; interquartile range, 75-90). Importantly, there were no significant differences in physical, mental, and cognitive functioning between patients with a negative versus positive discrepancy. Patients with a negative discrepancy had a higher education level and were more often unemployed. <b>Conclusions:</b> One year post-ICU, almost half of ICU survivors showed a discrepancy between calculated health and perceived health.

Annals of the American Thoracic SocietyVol. 22(2)
Johns Hopkins University (US), Radboud University Nijmegen (NL), Johns Hopkins Medicine (US), Maastricht University Medical Centre (NL), Radboud University Medical Center (NL), University Medical Center Utrecht (NL), Maastricht University (NL), Amphia Ziekenhuis (NL), Canisius-Wilhelmina Ziekenhuis (NL), Elkerliek Ziekenhuis (NL), Maas Clinic (US), Zuyderland Medisch Centrum (NL), Amsterdam University Medical Centers (NL), Rijnstate Hospital (NL), Ziekenhuis Bernhoven (NL), Jeroen Bosch Ziekenhuis (NL), Maaslandziekenhuis (NL)
Radboud Universitair Medisch Centrum
Openalex Percentile: Top 13%
Intensive Care Unit Cognitive Disorders
2.11
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