Journal of the Intensive Care Society最新文献

{"title":"Psychological impact of an intensive care admission for COVID-19 on patients in the United Kingdom.","authors":"Alicia Ac Waite, Mary Gemma Cherry, Stephen L Brown, Karen Williams, Andrew J Boyle, Brian W Johnston, Christina Jones, Peter Fisher, Ingeborg D Welters","doi":"10.1177/17511437241312113","DOIUrl":"10.1177/17511437241312113","url":null,"abstract":"<p><strong>Background: </strong>The psychological impact of surviving an admission to an intensive care unit (ICU) with COVID-19 is uncertain. The objective of the study was to assess the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in ICU survivors treated for COVID-19 infection, and identify risk factors for psychological distress.</p><p><strong>Methods: </strong>This observational study was conducted at 52 ICUs in the United Kingdom. Participants, treated for COVID-19 infection during an ICU admission of ⩾24 h, were recruited post-ICU discharge. Self-report questionnaires were completed at 3, 6 and/or 12 months. Symptoms of anxiety and depression were identified using the Hospital Anxiety and Depression Scale. PTSD was assessed using the Impact of Events Scale-6. Demographic, clinical, physical and psychosocial factors were considered as putative predictors of psychological distress.</p><p><strong>Results: </strong>1620 patients provided consent and 1258 (77.7%) responded to at least one questionnaire, with responses at 3 months (<i>N</i> = 426), 6 months (<i>N</i> = 656) and 12 months (<i>N</i> = 1050) following ICU admission. The following prevalence rates were found at 3, 6 and 12 months, respectively: anxiety in 28.8% (95% CI 24.6-33.1), 30.4% (95% CI 27.0-33.8) and 29.3% (95% CI 26.5-32.1); depression in 25.1% (21.0-29.3), 25.9% (22.7-29.3) and 24.0% (21.5-26.6); and PTSD in 43.5% (38.8-48.2), 44.3% (40.6-48.0) and 43.2% (40.2-46.1) of patients. Risk factors for psychological distress included a previous mental health diagnosis, unemployment or being on sick leave, and a history of asthma or COPD.</p><p><strong>Conclusion: </strong>Clinically significant symptoms of anxiety, depression and PTSD were common and persisted up to 12 months post-ICU discharge.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"11-20"},"PeriodicalIF":2.1,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health interventions in adult intensive care and recovery after critical illness to promote survivorship care.","authors":"Alisha A da Silva, Mark Merolli, Natalie A Fini, Catherine L Granger, Owen D Gustafson, Selina M Parry","doi":"10.1177/17511437241311105","DOIUrl":"https://doi.org/10.1177/17511437241311105","url":null,"abstract":"<p><p>Digital health refers to the field of using and developing technology to improve health outcomes. Digital health and digital health interventions (DHIs) within the area of intensive care and critical illness survivorship are rapidly evolving. Digital health interventions refer to technologies in clinical interventional format. A DHI could support clinicians with increasing clinical demands to have improved oversight of their patients' recovery trajectory or potential for deterioration, improve efficiency of healthcare delivery, and/or predict patient outcomes. In this narrative review, DHIs are explored across the continuum from in the ICU (recognising and managing clinical deterioration, identifying individuals at risk of poor recovery outcomes, tailoring care of the ICU patient and supporting the emotional needs of their family) through to integration in the primary care setting (adjuncts to ICU follow-up clinics and tracking, coaching and remote monitoring). Some of the DHIs discussed in this narrative review (to name a few) include interventions delivered via: Telehealth, artificial intelligence, wearable devices, virtual reality, and mobile phone applications (apps). Additionally, exploration of DHIs used successfully in other health fields are discussed to highlight potential opportunities for adaptation to the ICU context. Finally, the review provides an overview of considerations needed in the development of new DHIs. Development should consider the intended user, barriers to technology engagement and design. In the implementation of a new DHI, the World Health Organization (WHO) Global Strategy on Digital Health and appropriate evaluation should be considered prior to scaling up. Optimal implementation of DHIs could help address the key challenges of the ICU field.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":"26 1","pages":"96-104"},"PeriodicalIF":2.1,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring perspectives of supporting the process of dying, death and bereavement among critical care staff: A multidisciplinary, qualitative approach.","authors":"Elsa Joyce, Suzanne Guerin, Lindi Synman, Melanie Ryberg","doi":"10.1177/17511437241308672","DOIUrl":"10.1177/17511437241308672","url":null,"abstract":"<p><strong>Background: </strong>Dying and death in critical care settings can have particularly negative implications for the bereavement experience of family members, family interaction and the wellbeing of critical care staff. This study explored critical care staff perspectives of dying, death and bereavement in this context, and their role related to patients and their families, adopting a multidisciplinary perspective.</p><p><strong>Method: </strong>This study employed a descriptive exploratory qualitative design, using reflexive thematic analysis to interpret the data. Semi-structured interviews were conducted with 15 critical care staff from hospitals in the Republic of Ireland. Most participants were female (<i>n</i> = 11), with four male participants. Professional disciplines included nursing, dietetics, physiotherapy, anaesthesiology and medicine.</p><p><strong>Results: </strong>Key findings included supporting a 'nice death' for patients and their families, the challenges critical care staff experience, the need for better supports in critical care, and the need for change in current bereavement support provision given the diversity evident in the modern Irish population.</p><p><strong>Conclusion: </strong>This study suggests that the unique challenges faced by staff and families throughout the dying process may benefit from the development of additional psychological, educational, and infrastructural supports. Inconsistencies in supports across critical care units in Ireland were also identified. Future research should complement the current study and examine family members' experience of the dying process in critical care and their perspectives on supports provided.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"21-28"},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient activation and support needs in patients after ICU discharge: A UK survey of critical illness survivors.","authors":"Brenda O'Neill, Mark A Linden, Pam Ramsay, Alia Darweish Medniuk, Joanne Outtrim, Judy King, Bronagh Blackwood","doi":"10.1177/17511437241305266","DOIUrl":"10.1177/17511437241305266","url":null,"abstract":"<p><strong>Background: </strong>Understanding the degree to which patients are actively involved, confident and capable of engaging with self-management and rehabilitation could be an initial step in guiding individualised supportive strategies for people after critical illness.</p><p><strong>Aims: </strong>To assess the levels of active involvement with self management among ICU survivors using the Patient Activation Measure (PAM), explore associations between patient characteristics and PAM results, and investigate its relationship with patients' support needs at key transition points during the recovery process.</p><p><strong>Methods: </strong>Eligible participants received both the PAM and Support Needs After Critical care (SNAC) questionnaires by post. The return of the completed questionnaires was considered as consent to participate. Ethical approval was obtained (17/NI/0236). Descriptive statistics were used to summarise the data and Pearson's coefficient for correlations between variables.</p><p><strong>Findings: </strong>There were 200 completed PAM and SNAC questionnaires. PAM scores showed that levels of active involvement with self management fell into level 1 (<i>n</i> = 64; disengaged and overwhelmed, low confidence to self manage) and 2 (<i>n</i> = 70; still struggling), with considerably less participants achieving scores in level 3 (<i>n</i> = 51; taking action) and 4 (<i>n</i> = 15; pushing further). Lower patient activation levels were associated with higher support needs (r = -0.16, p = 0.02).</p><p><strong>Conclusion: </strong>We found that patient activation levels are low implying low knowledge, skills and confidence to self-manage after critical illness, and also that patients have support needs at various timepoints during recovery. Future research should focus on a longitudinal study to track changes in activation and support needs in the same patients over time and identify effective strategies to optimise recovery after critical illness.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"38-46"},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors to consider when designing post-hospital interventions to support critical illness recovery: Systematic review and qualitative evidence synthesis.","authors":"Jonathan Stewart, Ellen Pauley, Danielle Wilson, Judy Bradley, Nigel Hart, Danny McAuley","doi":"10.1177/17511437241308674","DOIUrl":"10.1177/17511437241308674","url":null,"abstract":"<p><strong>Background: </strong>Survivors of intensive care unit (ICU) admission experience significant deficits in health-related quality of life due to long-term physical, psychological, and cognitive sequelae of critical illness, which may persist for many years. There has been a proliferation of post-hospital interventions in recent years which aim to support ICU-survivors, however there is currently limited evidence to inform optimal approach. We therefore aimed to synthesise factors which impacted the implementation of these interventions from the perspective of healthcare providers, patients, and their carers, and to compare different intervention designs.</p><p><strong>Methods: </strong>We conducted a systematic review and synthesis of qualitative evidence using four databases (MEDLINE, EMBASE, CINAHL and Web of Science) which were searched from inception to May 2024. The extraction and synthesis of factors which impacted intervention implementation was informed by the domains of the Consolidated Framework for Implementation Research (CFIR) and Template for Intervention Description and Replication (TIDieR) checklist.</p><p><strong>Results: </strong>Thirty-seven studies were included, reporting on a range of interventions including follow-up clinics and rehabilitation programmes. We identified some overarching principles and specific intervention component and design factors which may support in the design of future strategies to improve outcomes for ICU survivors. For each intervention characteristic, various patient, staff, and setting factors were found to impact implementation. Considering how the intervention will rely on and integrate with existing outpatient and community resources is likely to be important.</p><p><strong>Conclusion: </strong>This review provides a framework to future research examining the optimal approach to supporting ICU survivor recovery following hospital discharge.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"80-95"},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal trend in post-discharge estimated glomerular filtration rate in intensive care survivors.","authors":"Rebecca M Glendell, Kathryn A Puxty, Martin Shaw, Malcolm Ab Sim, Jamie P Traynor, Patrick B Mark, Mark Andonovic","doi":"10.1177/17511437241308673","DOIUrl":"10.1177/17511437241308673","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) within the intensive care unit (ICU) is common but evidence is limited on longer-term renal outcomes. We aimed to model the trend of kidney function in ICU survivors using estimated glomerular filtration rate (eGFR), comparing those with and without AKI, and investigate potential risk factors associated with eGFR decline.</p><p><strong>Methods: </strong>This observational cohort study included all patients aged 16 or older admitted to two general adult ICUs in Scotland between 1st July 2015 and 30th June 2018 who survived to 30 days following hospital discharge. Baseline serum creatinine and subsequent values were used to identify patients with AKI and calculate eGFR following hospital discharge. Mixed effects modelling was used to control for repeated measures and to allow inclusion of several exploratory variables.</p><p><strong>Results: </strong>3649 patients were included, with 1252 (34%) experiencing in-ICU AKI. Patients were followed up for up to 2000 days with a median 21 eGFR measurements. eGFR declined at a rate of -1.9 ml/min/1.73m²/year (<i>p-</i>value < 0.001) in the overall ICU survivor cohort. Patients with AKI experienced an accelerated rate of post-ICU eGFR decline of -2.0 ml/min/1.73m²/year compared to a rate of -1.83 ml/min/1.73m²/year in patients who did not experience AKI (<i>p-</i>value 0.007). Pre-existing diabetes or liver disease and in-ICU vasopressor support were associated with accelerated eGFR decline regardless of AKI experience.</p><p><strong>Conclusions: </strong>ICU survivors experienced a decline in kidney function beyond that which would be expected regardless of in-ICU AKI. Long-term follow-up is warranted in ICU survivors to monitor kidney function and reduce morbidity and mortality.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"29-37"},"PeriodicalIF":2.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The legacy of the COVID-19 pandemic on critical care research: A descriptive interview study.","authors":"Natalie A Pattison, Geraldine O'Gara, Brian H Cuthbertson, Louise Rose","doi":"10.1177/17511437241301921","DOIUrl":"10.1177/17511437241301921","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic challenged both research and clinical teams in critical care to collaborate on research solutions to new clinical problems. Although an effective, nationally coordinated response helped facilitate critical care research, reprioritisation of research efforts towards COVID-19 studies had significant consequences for existing and planned research activity in critical care.</p><p><strong>Aims: </strong>Our aim was to explore the impact of the COVID-19 pandemic research prioritisation policies and practices on critical care research funded prior to the pandemic, the conduct of pandemic research, and implications for ongoing and future critical care research.</p><p><strong>Methods: </strong>We undertook a descriptive qualitative study recruiting research-active clinician researchers and research delivery team members working in critical care. We conducted digitally recorded, semi-structured interviews in 2021-2022. Framework Analysis was used to analyse the data.</p><p><strong>Results: </strong>We interviewed 22 participants comprising principal investigators, senior trial coordinators and research delivery nurses from across the UK. Six themes were identified: <i>Unit, organisational and national factors; Study specific factors; Resources; Individual/clinician factors; Family/patient factors; Contextual factors.</i> These themes explained how a nationally coordinated response during the pandemic affected individuals, studies and wider organisations in managing the research response in critical care, highlighting future implications for critical care research.</p><p><strong>Conclusion: </strong>Harnessing the collective response seen in the COVID-19 pandemic in critical care could better support integration of research activity into routine critical care activities. Future endeavours should focus on workforce preparations, contingency planning, strategies for study prioritisation and integration of research as part of the continuum of clinical care.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"53-60"},"PeriodicalIF":2.1,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Animal-assisted intervention services across UK intensive care units: A national service evaluation.","authors":"Sam Wright, Holly McAree, Megan Hosey, Kate Tantam, Bronwen Connolly","doi":"10.1177/17511437241301000","DOIUrl":"10.1177/17511437241301000","url":null,"abstract":"<p><strong>Background: </strong>Animal-assisted interventions (AAI) can provide psychological support to critical care patients during their intensive care unit (ICU) admission. However, there are currently no data on AAI services across UK ICUs. The current study therefore aims to (i) determine how many ICUs in the UK offer services, (ii) characterise available services and (iii) explore and review local documentation for service oversight.</p><p><strong>Methods: </strong>A service evaluation comprising two parts; a national survey of UK ICU's, analysed using descriptive statistics, and review of local service oversight documents, analysed using a framework approach.</p><p><strong>Results: </strong>Responses from 74 sites (/242, 30.6%) were included in survey analysis. AAI services were present at 32 sites (/74, 43.2%), of which 30 offered animal-assisted activity services alone and 2 offered both animal-assisted activity and animal-assisted therapy services. Animal-assisted activity services were typically delivered on a weekly basis, lasting 30-60 min and with dogs the sole animal employed. Concern over infection prevention and control was the most common barrier to service provision, as well as a lack of supporting evidence. Sixteen sites provided 27 oversight documents for analysis, that highlighted unique and shared responsibilities between critical care staff and animal therapy handlers, including aspects of administration, welfare and infection control.</p><p><strong>Conclusion: </strong>From a small sample, AAI services were available in less than half of ICUs. Empirical value of interventions is countered by current lack of definitive evidence of effectiveness, which should be addressed before wider implementation of AAI services and the associated resource requirements, is undertaken.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"68-79"},"PeriodicalIF":2.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes for older patients with subarachnoid haemorrhage who require admission to an Australian intensive care unit.","authors":"Jeremy Sharman, Natasha Turner, Amalia Karahalios, Ben Sansom, Adam M Deane, Mark P Plummer","doi":"10.1177/17511437241301916","DOIUrl":"10.1177/17511437241301916","url":null,"abstract":"<p><strong>Background: </strong>Advanced age is an independent risk factor for poor outcomes following aneurysmal subarachnoid haemorrhage (SAH). However, Australian data are lacking. Our aim was to evaluate outcomes for older patients admitted to an Australian intensive care unit for management of aneurysmal SAH.</p><p><strong>Methods: </strong>We conducted a single centre retrospective observational study looking at adult patients admitted with aneurysmal SAH to an Intensive Care Unit (ICU) over a 10-year period. Patients were grouped by age; <70 years, 70-79 years, ⩾80 years, and were of sufficient complexity to be unsuitable for our neurosurgical high-dependency unit. The primary outcome was in-hospital mortality. Secondary outcomes were ICU and hospital length of stay, and discharge destination.</p><p><strong>Results: </strong>Of 372 patients admitted to ICU with aneurysmal SAH, 302 (82%) were younger (<70 years), 46 (12%) were septuagenarians and 24 (6%) were octogenarians. There were no differences between clinical or radiological grade of aneurysmal SAH between age cohorts. When compared to the patients younger than 70 years, there was increased odds of dying for those 70-79 and ⩾80 years (70-79: OR 1.98, 95% CI 0.93, 4.20 <i>p</i> = 0.077; ⩾80: OR 4.01, 95% CI 1.55, 10.35 <i>p</i> = 0.004). There were no associations between age and duration of admission. Only 6% of patients aged ⩾70 years were discharged home alive.</p><p><strong>Conclusion: </strong>It was uncommon for patients over 70 years of age who present with a SAH to be discharged home from hospital, and those aged ⩾80 are four times more likely to die in hospital than younger patients.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"47-52"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes after critical care admission in people with a learning disability.","authors":"Ben Messer, Emily Harrison, Alison Carter, Ian Clement, Holly Gillott, Ching Khai Ho, Thomas Ross, Nicholas Lane, Hilary Tedd","doi":"10.1177/17511437241301922","DOIUrl":"10.1177/17511437241301922","url":null,"abstract":"<p><strong>Introduction: </strong>People with learning disabilities experience worse healthcare outcomes than the general population. There is evidence that they are more likely to experience avoidable mortality and less likely to receive critical care interventions during an acute illness. Decisions regarding critical care admission or intervention must be based on evidence of whether a patient will receive lasting benefit from a critical care admission. We therefore investigated outcomes from critical care admissions in people with learning disabilities and compared them to general critical care patients.</p><p><strong>Methods: </strong>People with learning disabilities who were admitted to our critical care unit were identified via our coding department, from the Intensive Care National Audit and Research Centre (ICNARC) database and from our local electronic patient record. Mortality and length of stay outcomes for people with learning disabilities were recorded following critical care admission over a 5 years period and compared with the general critical care cohort over the same 5 years period. Longer term survival of patients with learning disabilities was also recorded.</p><p><strong>Results: </strong>297 critical care admissions in 176 people with learning disabilities were identified. The general critical care cohort included 6224 admissions in 4976 patients. The standardised mortality rate in people with learning disabilities admitted to critical care was 0.59 compared to the general critical care cohort which was 0.98. Mortality outcomes remained better in patients with learning disabilities compared to the general critical care cohort in invasively ventilated patients and in people with profound and multiple learning disability. Critical care length of stay was longer in people with learning disabilities. 12 month mortality was 14.8% in the learning disability cohort. By the end of the study, 23.9% of people with learning disabilities had died after a mean of 482 days following their first critical care admission. Patients who are currently still alive after having survived to hospital discharge following critical care admission have lived an average of 1129 days. After only 7.4% of critical care admissions in people with learning disabilities was there an increase in dependence on assistance in activities of daily living.</p><p><strong>Discussion: </strong>We have shown that people with learning disabilities are more likely to survive following a critical care admission than general critical care patients. This is regardless of whether they were invasively ventilated or whether they had profound and multiple learning disabilities. Critical care admission and invasive ventilation are associated with good short and longer term mortality.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"61-67"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}