Dataset Information

Prediction of Long-Term Physical, Mental, and Cognitive Problems Following Critical Illness: Development and External Validation of the PROSPECT Prediction Model.

ABSTRACT:

Objectives

ICU survivors often suffer from long-lasting physical, mental, and cognitive health problems after hospital discharge. As several interventions that treat or prevent these problems already start during ICU stay, patients at high risk should be identified early. This study aimed to develop a model for early prediction of post-ICU health problems within 48 hours after ICU admission.

Design

Prospective cohort study in seven Dutch ICUs.

Setting/patients

ICU patients older than 16 years and admitted for greater than or equal to 12 hours between July 2016 and March 2020.

Interventions

None.

Measurements and main results

Outcomes were physical problems (fatigue or ≥ 3 new physical symptoms), mental problems (anxiety, depression, or post-traumatic stress disorder), and cognitive impairment. Patient record data and questionnaire data were collected at ICU admission, and after 3 and 12 months, of 2,476 patients. Several models predicting physical, mental, or cognitive problems and a composite score at 3 and 12 months were developed using variables collected within 48 hours after ICU admission. Based on performance and clinical feasibility, a model, PROSPECT, predicting post-ICU health problems at 3 months was chosen, including the predictors of chronic obstructive pulmonary disease, admission type, expected length of ICU stay greater than or equal to 2 days, and preadmission anxiety and fatigue. Internal validation using bootstrapping on data of the largest hospital ( n = 1,244) yielded a C -statistic of 0.73 (95% CI, 0.70-0.76). External validation was performed on data ( n = 864) from the other six hospitals with a C -statistic of 0.77 (95% CI, 0.73-0.80).

Conclusions

The developed and externally validated PROSPECT model can be used within 48 hours after ICU admission for identifying patients with an increased risk of post-ICU problems 3 months after ICU admission. Timely preventive interventions starting during ICU admission and follow-up care can prevent or mitigate post-ICU problems in these high-risk patients.

SUBMITTER: van Sleeuwen D

PROVIDER: S-EPMC10793772 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

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Publications

Prediction of Long-Term Physical, Mental, and Cognitive Problems Following Critical Illness: Development and External Validation of the PROSPECT Prediction Model.

van Sleeuwen Dries D Zegers Marieke M Ramjith Jordache J Cruijsberg Juliette K JK Simons Koen S KS van Bommel Daniëlle D Burgers-Bonthuis Dominique D Koeter Julia J Bisschops Laurens L A LLA Janssen Inge I Rettig Thijs C D TCD van der Hoeven Johannes G JG van de Laar Floris A FA van den Boogaard Mark M

Critical care medicine 20231215 2

<h4>Objectives</h4>ICU survivors often suffer from long-lasting physical, mental, and cognitive health problems after hospital discharge. As several interventions that treat or prevent these problems already start during ICU stay, patients at high risk should be identified early. This study aimed to develop a model for early prediction of post-ICU health problems within 48 hours after ICU admission.<h4>Design</h4>Prospective cohort study in seven Dutch ICUs.<h4>Setting/patients</h4>ICU patients ...[more]

PMID: 38099732

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Dataset Information

Prediction of Long-Term Physical, Mental, and Cognitive Problems Following Critical Illness: Development and External Validation of the PROSPECT Prediction Model.

Objectives

Design

Setting/patients

Interventions

Measurements and main results

Conclusions

Publications

Prediction of Long-Term Physical, Mental, and Cognitive Problems Following Critical Illness: Development and External Validation of the PROSPECT Prediction Model.

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