Post-intensive care unit clinics in Canada: a national survey
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Post-intensive care unit clinics in Canada: a national survey Kallie Stapleton, MBBS . Matthew Jefkins, MD . Christopher Grant, MD, FRCPC . J. Gordon Boyd, MD, PhD, FRCPC
Received: 14 January 2020 / Revised: 26 May 2020 / Accepted: 29 May 2020 Ó Canadian Anesthesiologists’ Society 2020
To the Editor, Post-intensive care unit syndrome (PICS) is defined as new or worsening impairment in physical, cognitive, or mental health status after critical illness that persists beyond the acute care setting.1 Post-intensive care unit syndrome is estimated to occur in 25–50% of intensive care unit (ICU) survivors. The recognition of this syndrome’s impact on the quality of life for ICU survivors and their families has been the impetus to develop post-ICU clinics to diagnose and manage PICS.2 The purpose of our study was twofold. First, we wanted to identify the number of post-ICU clinics across Canada. Secondly, for established clinics, we aimed to understand the infrastructure and processes of care for PICS patients. Survey questions were generated by the study team based
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12630-020-01741-1) contains supplementary material, which is available to authorized users. Kallie Stapleton and Matthew Jefkins have contributed equally to this work. K. Stapleton, MBBS (&) Department of Critical Care, Queen’s University, Kingston, ON, Canada e-mail: [email protected] M. Jefkins, MD Department of Internal Medicine, Kingston, ON, Canada C. Grant, MD, FRCPC Division of Physical Medicine and Rehabilitation, University of Calgary, Calgary, AB, Canada J. G. Boyd, MD, PhD, FRCPC Department of Critical Care Medicine, Department of Neurology, Queen’s University, Kingston, ON, Canada
on previous research.3 Following item reduction, a 15question electronic survey (Qualtrics, Provo, UT, USA) was delivered to ICU managers across Canada (see eAppendix in the Electronic Supplementary Material). A list of the ICUs across Canada was obtained with permission from a study completed by Fowler et al.4 In total, 271 hospitals with adult ICUs were contacted via telephone to obtain the unit manager’s email address; and 246 electronic surveys were distributed. Participation was optional and anonymous. Survey completion was encouraged with follow-up emails and telephone calls. No financial incentive was provided. Data were summarized with descriptive statistics. The response rate was 52%. Most ICUs had 6–10 beds (n = 36) or 11–20 beds (n = 36). Referral to a post-ICU clinic was rare (n = 6); the six existing clinics were all established within the previous four years and receive referrals from medical/cardiac, neurologic/neurosurgical, surgical, and mixed ICUs (Figure). Few (n = 11) ICUs had plans to develop a post-ICU clinic. Clinic referral criteria included significant delirium (2/6), ICU stay greater than four or seven days (1/6 and 2/6, respectively), extracorporeal life support (1/6), direct discharge home from the ICU (1/6), and invasive ventila
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