Impact of follow-up consultations for ICU survivors on post-ICU syndrome: a systematic review and meta-analysis

Research output: Contribution to journalJournal articleResearchpeer-review

PURPOSE: To evaluate the impact of routine follow-up consultations versus standard of care for intensive care unit (ICU) survivors.

METHODS: Systematic literature review from five databases (Cochrane CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL), reference lists, citation tracking, and ongoing/unpublished trials. Randomized controlled trials investigating post-ICU consultations in adults with outcomes such as quality of life (QOL), anxiety, depression, posttraumatic stress disorder (PTSD), physical ability, cognitive function, and return to work were included. Two reviewers extracted data and assessed quality independently. The mean differences, risk ratios, and 95 % confidence intervals were calculated depending on outcome measures.

RESULTS: From 1544 citations, five trials were included (855 patients). The overall risk of bias was low in two trials, unclear in two trials, and high in one trial. The overall quality of evidence was low. The trials assessed follow-up interventions defined as consultations informing survivors about their ICU stay. One trial found no effect on QOL. Pooling data from two trials (n = 374) showed a protective effect on risk of new onset PTSD at 3-6 months after ICU (risk ratio 0.49, 95 % CI 0.26-0.95). There was no effect on other outcomes.

CONCLUSIONS: The evidence indicates that follow-up consultations might reduce symptoms of PTSD at 3-6 months after ICU discharge in ICU survivors, but without affecting QOL and other outcomes investigated. This review highlights that planning of future RCTs should aim to standardize interventions and outcome measures to allow for comparisons across studies.

Original languageEnglish
JournalIntensive Care Medicine
Volume41
Issue number5
Pages (from-to)763-75
Number of pages13
ISSN0342-4642
DOIs
Publication statusPublished - May 2015

    Research areas

  • Adult, Aged, Aged, 80 and over, Anxiety, Cognition, Critical Care, Female, Follow-Up Studies, Humans, Male, Middle Aged, Outcome Assessment (Health Care), Quality of Life, Stress Disorders, Post-Traumatic, Survivors

ID: 161192058