Post-ICU Outcomes in a Low-Resource Setting: A Cohort Study From Rwanda

IMPORTANCE: Survivorship after critical illness in low-resource settings is inadequately characterized. OBJECTIVES: To assess 90-day mortality and multidimensional recovery following ICU discharge. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort of adults discharged alive from a national referral ICU in Rwanda. MAIN OUTCOMES AND MEASURES: Mortality, functional status (Modified Barthel Index), cognition (Mini-Mental State Examination), and anxiety and depression (Generalized Anxiety Disorder-7, Patient Health Questionnaire-9). RESULTS: Among 62 participants (mean age 41 ± 16 yr; 50% male), 90-day mortality was 12.9%. By day 90, only 48.4% achieved full functional independence, while 36.8% remained impaired. Normal cognition increased from 22.6% at discharge to 51.6% at follow-up. Notably, 30.6% of survivors reported severe anxiety or depression. CONCLUSIONS AND RELEVANCE: ICU survivorship in this low-resource setting is marked by substantial persistent morbidity. These findings underscore critical gaps in post-ICU care and the urgent need for scalable, context-appropriate survivorship strategies.