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Review
. 2018 Oct;24(5):401-409.
doi: 10.1097/MCC.0000000000000533.

Understanding patient-important outcomes after critical illness: a synthesis of recent qualitative, empirical, and consensus-related studies

Affiliations
Review

Understanding patient-important outcomes after critical illness: a synthesis of recent qualitative, empirical, and consensus-related studies

Victor D Dinglas et al. Curr Opin Crit Care. 2018 Oct.

Abstract

Purpose of review: Patients surviving critical illness frequently experience long-lasting morbidities. Consequently, researchers and clinicians are increasingly focused on evaluating and improving survivors' outcomes after hospital discharge. This review synthesizes recent research aimed at understanding the postdischarge outcomes that patients consider important (i.e., patient-important outcomes) for the purpose of advancing future clinical research in the field.

Recent findings: Across multiple types of studies, patients, family members, researchers, and clinicians have consistently endorsed physical function, cognition, and mental health as important outcomes to evaluate in future research. Aspects of social health, such as return to work and changes in interpersonal relationships, also were noted in some research publications. Informed by these recent studies, an international Delphi consensus process (including patient and caregiver representatives) recommended the following core set of outcomes for use in all studies evaluating acute respiratory failure survivors after hospital discharge: survival, physical function (including muscle/nerve function and pulmonary function), cognition, mental health, health-related quality of life, and pain. The Delphi panel also reached consensus on recommended measurement instruments for some of these core outcomes.

Summary: Recent studies have made major advances in understanding patient-important outcomes to help guide future clinical research aimed at improving ICU survivors' recovery.

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Figures

Box 1
Box 1
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FIGURE 1
FIGURE 1
Summary of thematic analysis from qualitative interviews of acute respiratory failure survivors [31] organized using the National Institutes of Health's Patient-Reported Outcomes Measurement Information System framework [32].
FIGURE 2
FIGURE 2
Summary of the modified Delphi consensus process.
FIGURE 3
FIGURE 3
Summary of understanding patient-important outcomes in creating a core outcome set [▪▪]/core outcome measurement set [▪▪].

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