Critical Care Medicine最新文献

{"title":"Association of Medical Burden and Capacity Changes With Clinical Outcomes Among Patients Without COVID-19 During the Pandemic: A Multicenter Retrospective Cohort Study.","authors":"Masaaki Sakuraya, Tomoyuki Sugimoto, Kazuya Kikutani, Chikashi Takeda, Daisuke Kasugai, Hiromu Okano, Yoshitaka Aoki, Hiroki Shimada, Daisuke Kawakami, Akira Hirata, Takushi Santanda, Masaki Nakane, Junji Kumasawa, Toko Fukushima, Keisuke Ota, Naoki Moriyama, Masatoshi Uchida, Hiromasa Irie, Kenzo Ishii, Keisuke Mataichi, Junji Shiotsuka, Kensuke Sugimoto, Naoya Kobayashi, Reiki Kumashiro, Yukiko Koyama, Nobuaki Shime","doi":"10.1097/CCM.0000000000006785","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006785","url":null,"abstract":"<p><strong>Objectives: </strong>The spillover impact of the COVID-19 pandemic on patients without COVID-19 in ICUs should be assessed. We aimed to assess the association of ICUs' medical burden and capacity changes with clinical outcomes in such patients during the COVID-19 pandemic.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Twenty-three ICUs in Japan.</p><p><strong>Patients: </strong>Patients without COVID-19 in ICUs from January 2019 to February 2023.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>These ICUs completed a web-based questionnaire on medical burden and capacity limitations in November 2023, and they were classified as having a limited capacity if their scores exceeded the median; otherwise, they were categorized as having a maintained capacity. The primary outcome was the standardized mortality ratio (SMR), calculated with the Acute Physiology and Chronic Health Evaluation III-j model, compared with the pre-pandemic level. Using individual-level patient data, a generalized linear Poisson mixed-effects model including an offset-time term was employed to assess the association of capacity limitation, the number of patients with COVID-19, and ICU bed occupancy on the day of admission, with hazard ratios for in-hospital death. Nine and fourteen ICUs had a limited capacity (25,568 patients) and a maintained capacity (45,068 patients), respectively. SMRs increased in four epidemic waves in the ICUs with a limited capacity but in only one wave in those with a maintained capacity. After adjustment, capacity limitation (hazard ratio, 1.19; 95% CI, 1.01-1.41; p = 0.04) and the number of patients with severe COVID-19 (per five patients; hazard ratio, 1.09; 95% CI, 1.03-1.16; p = 0.002) were associated with in-hospital mortality, but ICU bed occupancy was not.</p><p><strong>Conclusions: </strong>SMRs increased more frequently in ICUs with a limited capacity during the pandemic. Our findings emphasize the need for proactive strategies to mitigate medical burden and capacity limitations for future preparedness.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consideration of Sociodemographics in Sepsis Risk Prediction: Implications and Next Steps.","authors":"Deepshikha C Ashana, William F Parker","doi":"10.1097/CCM.0000000000006777","DOIUrl":"10.1097/CCM.0000000000006777","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex- and Age-Related Differences in Post-Burn Pathophysiology.","authors":"Diana Julia Tedesco, Maria Fernanda Hutter, Fadi Khalaf, Gregory R Pond, Marc G Jeschke","doi":"10.1097/CCM.0000000000006789","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006789","url":null,"abstract":"<p><strong>Objectives: </strong>Sex and its effects on outcomes after burn are controversially discussed. In particular, the impact of sex on physiologic responses post-burn remains largely unknown. To bridge this knowledge gap, this study aimed to explore outcomes and the underlying pathophysiological responses in males and females across different age groups.</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Setting: </strong>Tertiary burn center.</p><p><strong>Patients: </strong>Adult burn patients (≥ 18 yr) admitted with an acute burn injury.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>We included all patients (≥ 18 yr) admitted with acute burn injuries between 2006 and 2021. Patients were stratified based on sex assigned at birth and age group: adult (< 60 yr) vs. older adult (≥ 60 yr). Clinical laboratory measures and inflammatory markers were compared throughout hospitalization between male and female burn patients within each age group. Outcomes included 30-day mortality, in-hospital complications, organ biomarkers, and inflammatory cytokine responses. A total of 2321 patients were included. Adult females experienced greater mortality (1% vs. 2%; p < 0.05) and increased skin graft loss (5% vs. 9%; p < 0.05) compared with their male counterparts. Furthermore, among adults, female sex was an independent predictor of mortality in a multivariate model (odds ratio, 3.6; 95% CI, 1.3-9.6; p < 0.05). Adult females showed acute decreases in pro-inflammatory cytokines (interferon-γ, interleukin [IL]-6, IL-1β, tumor necrosis factor-α; p < 0.05). Interestingly, no differences in mortality or complications were observed between older adult males and females. Older adult males and females also showed similar inflammatory responses and limited differences in organ function.</p><p><strong>Conclusions: </strong>In this large cohort study, we observed that adult females show increased mortality compared with their male counterparts. Differences in inflammatory responses underlie this observation, contributing to the observed poor outcomes. Importantly, sex differences in post-burn responses appear to diminish with age, highlighting the importance of deepening our understanding of the underlying physiologic mechanisms to optimize patient care.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Incidence of Arterial Pressure Line Insufficiency Between Polyethylene and Polyurethane Catheters in the ICU: A Randomized Study.","authors":"Kimito Minami, Masahiro Kazawa, Tatsutoshi Shimatani, Masahiro Morinaga, Akira Shimokawa, Takuma Maeda, Muneyuki Takeuchi","doi":"10.1097/CCM.0000000000006794","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006794","url":null,"abstract":"<p><strong>Objectives: </strong>Continuous arterial pressure monitoring is crucial for critically ill patients. However, the impact of catheter type on arterial line insufficiency remains unexamined.</p><p><strong>Design: </strong>Double-blinded, superiority, randomized controlled trial.</p><p><strong>Setting: </strong>A cardiovascular center in Japan.</p><p><strong>Patients: </strong>Adult patients scheduled for elective cardiovascular surgery and postoperative admission to the ICU.</p><p><strong>Interventions: </strong>Patients were randomly assigned either polyethylene or polyurethane catheters.</p><p><strong>Measurements and main results: </strong>The outcome of interest was arterial line insufficiency, defined by one or more of the following four criteria: flattened or overdamped blood pressure waveform, sluggish free backflow of blood (> 2 s) when the stopcock was opened to the atmosphere, inability to draw blood from the arterial line, and inability to flush the catheter. The frequency of arterial line insufficiency was observed at the first noon after ICU admission. An interim analysis using the chi-square test was performed after half of the participants were enrolled, with early termination if p value of less than 0.005 based on the O'Brien-Fleming method. Interim analysis of 132 patients revealed significant differences in primary outcomes, leading to early termination of the trial. Arterial line insufficiency occurred in four of 69 patients (5.8%) with polyethylene catheters and 18 of 63 patients (28.6%) with polyurethane catheters (relative risk, 0.15; 95% CI, 0.05-0.48; p = 0.001).</p><p><strong>Conclusions: </strong>This study demonstrated a lower occurrence rate of arterial line insufficiency with polyethylene arterial catheters than polyurethane catheters.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Rhythm Conversions and the Outcome in Refractory Out-of-Hospital Cardiac Arrest: Extracorporeal Versus Conventional Resuscitation.","authors":"Stepan Havranek, Jakub Neuhöfer, Michaela Vesela, Petra Kavalkova, Daniel Rob, Zdenka Fingrova, Jana Smalcova, Ondrej Franek, Michal Huptych, Milan Dusik, Jan Pudil, Vojtech Weiss, Ales Linhart, Jan Belohlavek","doi":"10.1097/CCM.0000000000006787","DOIUrl":"10.1097/CCM.0000000000006787","url":null,"abstract":"<p><strong>Objectives: </strong>A Prague out-of-hospital cardiac arrest (OHCA) study has demonstrated that an invasive approach (early transport to the hospital, extracorporeal cardiopulmonary resuscitation [ECPR]) is a feasible and effective treatment strategy in refractory OHCA. This post hoc analysis of the Prague OHCA study aimed to stratify the prognosis of patients according to the detailed course of heart rhythm during prehospital and early hospital periods.</p><p><strong>Design, setting, and patients: </strong>This analysis included all 256 patients (median age 58, 17% females) randomized to the Prague OHCA study. The sequence of heart rhythms during the prehospital period was analyzed in terms of neurologic outcomes after 180 days. The primary outcome was a composite of survival with Cerebral Performance Category 1 or 2 at 180 days.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Within the study cohort, 156 (61%) manifested ventricular fibrillation (VF), 45 pulseless electrical activity, and 55 asystole as the initial rhythm. Patients with an initial VF who reached a sustained recovery of spontaneous circulation (ROSC) had the highest proportion of reaching a primary outcome (32/44 [73%]). Patients who had one or more episodes of asystole during cardiopulmonary resuscitation had the lowest rate of primary endpoint (5/39 [13%]). Patients who experienced intermittent ROSC showed a higher success rate in achieving the primary outcome when treated with an invasive-based approach (including ECPR) compared with the conventional strategy (26/34 [76%] vs. 24/50 [48%]; p < 0.05).</p><p><strong>Conclusions: </strong>Achieving ROSC is the best prognostic marker in OHCA patients with an initially refractory VF. Patients with intermittent ROSC after the initial VF and ongoing VF seem to be optimal candidates for an invasive approach. Asystole detection at any time during resuscitation is a strong negative prognostic marker, irrespective of the initial rhythm.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sepsis Chain of Survival: A Comprehensive Framework for Improving Sepsis Outcomes.","authors":"Jorge L Hidalgo, Vishakha K Kumar, Samuel O Akech, Sheila N Myatra, Shevin T Jacob, Teresa Kortz, Amanda A Vasquez, Maria Cristina Jiménez Bazzano, Marilia Diaz, Jennifer Del Rio Rodríguez, Ana Luisa Najera Garcia, Rocio Giron, Judith Jacobi, Maureen A Madden, Vinay Nadkarni","doi":"10.1097/CCM.0000000000006796","DOIUrl":"10.1097/CCM.0000000000006796","url":null,"abstract":"<p><p>The \"Chain of Survival\" concept, developed for cardiac arrest, emphasizes a seamless and interconnected set, of time-critical interventions that are not strictly linear, to improve survival. This paradigm of urgent recognition and response to life-threatening conditions has evolved to apply to acute medical conditions, including sepsis. The \"Sepsis Chain of Survival\" underscores the importance of early recognition, prompt emergency medical services activation, timely antimicrobial administration and appropriate fluid resuscitation, optimized critical care management, effective source control and infection management, and comprehensive post-sepsis care. By adopting this approach, healthcare systems can improve sepsis outcomes through a coordinated, multifaceted strategy. This model highlights the critical role of public and healthcare worker awareness, education, community response, and continuous monitoring. Addressing the importance and interdependence of each link, this framework aims to improve survival rates and patient recovery by ensuring timely and effective sepsis management across diverse resource settings in infants, children, and adults.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Risk to Recovery: Predicting Quality of Life After Critical Illness.","authors":"Kimia Honarmand","doi":"10.1097/CCM.0000000000006776","DOIUrl":"10.1097/CCM.0000000000006776","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Hospital-Level Median Door-to-Extracorporeal Cardiopulmonary Resuscitation Time on the Prognosis of Patients With Refractory Out-of-Hospital Cardiac Arrest.","authors":"Daisuke Kasugai, Yohei Okada, Yuka Mizutani, Junta Honda, Toru Kondo, Shingo Kazama, Takanori Yamamoto","doi":"10.1097/CCM.0000000000006808","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006808","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of hospital-level median door-to-extracorporeal cardiopulmonary resuscitation (ECPR) time on survival and neurologic outcomes in patients with out-of-hospital cardiac arrest (OHCA) requiring ECPR.</p><p><strong>Design: </strong>Secondary analysis of the Japanese Association for Acute Medicine OHCA registry, a nationwide Japanese database of OHCA patients.</p><p><strong>Setting: </strong>Fifty-three hospitals across Japan.</p><p><strong>Patients: </strong>Adult patients who underwent ECPR between 2014 and 2021 were included. Hospitals were categorized into \"rapid\" or \"delayed\" groups based on their median door-to-ECPR times.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>The primary outcome was 30-day survival. Secondary outcomes included 30-day and 90-day survival with favorable neurologic outcomes. Propensity score weighting was applied to adjust for confounders. In total, 2136 patients treated at 53 hospitals were included. Hospitals with shorter median door-to-ECPR times had higher 30-day survival rates (odds ratio [OR], 1.36; 95% CI, 1.21-1.53). Neurologic outcomes were better in the rapid hospital group at both 30 days (OR, 1.47; 95% CI, 1.24-1.73) and 90 days (OR, 1.47; 95% CI, 1.25-1.73) follow-ups.</p><p><strong>Conclusions: </strong>Hospital-level median door-to-ECPR time is a crucial predictor of survival and neurologic outcomes in OHCA patients requiring ECPR. Shorter door-to-ECPR times should be considered a key quality metric for ECPR processes.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin Use in the ICU: A Systematic Review and Meta-Analysis.","authors":"Brian Hao Yuan Tang, Judith Manalo, Saifur R Chowdhury, J Matthew Aldrich, Gerald L Weinhouse, Makayla Cordoza, Patricia R Louzon, Michele C Balas, Joanna L Stollings, Molly McNett, Karin Dearness, Jose Estrada-Codecido, Dipayan Chaudhuri, Kallirroi Laiya Carayannopoulos, Kimberley Lewis","doi":"10.1097/CCM.0000000000006767","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006767","url":null,"abstract":"<p><strong>Objectives: </strong>Melatonin has wide-ranging effects on the body, including the regulation of circadian rhythm, and potentiation of cellular immune and antioxidant activities. In critically ill patients, endogenous melatonin has been shown to be markedly deranged and reduced. Therefore, the purpose of this systematic review and meta-analysis was to determine if exogenous supplementation of melatonin improves patient-centered outcomes.</p><p><strong>Data sources: </strong>We searched five electronic databases.</p><p><strong>Study selection: </strong>Randomized clinical trials (RCTs) that compared melatonin to no melatonin in adults admitted to the ICU were identified.</p><p><strong>Data extraction: </strong>We aggregated data as relative risks, mean differences (MDs), and standard mean differences (SMDs) using a random-effects model. Supporting evidence for each effect was evaluated for certainty using the Grading Recommendations, Assessment, Development, and Evaluations approach.</p><p><strong>Data synthesis: </strong>In total, 32 RCTs (n = 3895 patients) were included. We found that melatonin may reduce delirium (relative risk [RR] 0.72; 95% CI, 0.58-0.89; low certainty), may slightly reduce ICU length of stay (MD -0.57 d; 95% CI, -0.95 to -0.18 d; low certainty), and may improve reported sleep quality (SMD 0.54; 95% CI, 0.01-1.07; low certainty). Melatonin may result in a slight reduction in the frequency of adverse events (low certainty). Evidence was uncertain with regards to the frequency of sleep awakenings, anxiety level, agitation, and post-traumatic stress disorder incidence (all very low certainty), as well as to ICU mortality and post-ICU functional status (both low certainty).</p><p><strong>Conclusions: </strong>Our findings suggest that melatonin administration in the critically ill may improve perceived sleep and reduce delirium, without increasing adverse effects. Certainty of evidence was negatively affected by the risk of bias and inconsistency. Future RCTs should focus on identifying optimal dosing, administration timing, improving measurements of sleep outcomes, and target populations.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Quality of Life After Intensive Care: A Systematic Review and Meta-Analysis.","authors":"Weilin Jiang, Qiqi Ni, Chuchu Zhang, Yuheng Dong, Jia Yi, Ran Yan, Zhenzhen Huang, Li Wang, Weijing Sui, Xiaoyan Gong, Yiyu Zhuang","doi":"10.1097/CCM.0000000000006770","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006770","url":null,"abstract":"<p><strong>Objectives: </strong>The factors influencing quality of life (QOL) after intensive care are diverse and complex, and the QOL levels remain unclear. This systematic review and meta-analysis aimed to identify the factors influencing QOL and QOL levels in post-ICU patients.</p><p><strong>Data sources: </strong>We searched eight databases: PubMed, Embase, EBSCOhost, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WeiPu, and WanFang, from inception to October 15, 2024.</p><p><strong>Study selection: </strong>We included observational studies that examined factors influencing QOL in post-ICU patients.</p><p><strong>Data extraction: </strong>Two independent reviewers extracted and recorded the data.</p><p><strong>Data synthesis: </strong>A total of 65 studies, encompassing 17,298 post-ICU patients, met the inclusion criteria. The key pre-ICU factors are advanced age (per 1-yr increase) (β: -0.045 [95% CI, -0.057 to -0.033]) and female gender (odds ratio: 1.104 (95% CI, 1.035-1.177]). The key intra-ICU factors are length of ICU stay (per 1-d increase) (β: -0.012 [95% CI, -0.019 to -0.005]), length of mechanical ventilation (per 1-d increase) (β: -0.005 [95% CI, -0.009 to -0.001]), and length of hospital stay (per 1-d increase) (β: -0.107 [95% CI, -0.161 to -0.054]). The pooled overall QOL score was 58.835 (95% CI, 52.935-64.735), the pooled physical component summary (PCS) score was 49.517 (95% CI, 45.781-53.253), the pooled mental component summary (MCS) score was 53.509 (95% CI, 50.301-56.718), and the pooled overall QOL index was 0.750 (95% CI, 0.713-0.787).</p><p><strong>Conclusions: </strong>Most pre-ICU and intra-ICU factors demonstrated strong associations with post-ICU QOL. The QOL in post-ICU patients remains at a moderate level, with the PCS score indicating greater impairment than the MCS score. Further research is highly recommended to explore effective intervention strategies to improve QOL in post-ICU patients, particularly concerning their physical well-being.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}