Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Jan 1;53(1):e74-e86.
doi: 10.1097/CCM.0000000000006461. Epub 2024 Oct 24.

Associations Between Physical, Cognitive, and Mental Health Domains of Post-Intensive Care Syndrome and Quality of Life: A Longitudinal Multicenter Cohort Study

Bram Tilburgs  1 , Koen S Simons  2 , Stijn Corsten  3 , Brigitte Westerhof  4 , Thijs C D Rettig  5 , Esther Ewalds  6 , Marieke Zegers  1 , Mark van den Boogaard  1
Affiliations
Multicenter Study

Associations Between Physical, Cognitive, and Mental Health Domains of Post-Intensive Care Syndrome and Quality of Life: A Longitudinal Multicenter Cohort Study

Bram Tilburgs et al. Crit Care Med. .

Abstract

Objectives: To explore associations between the physical, cognitive, and mental post-intensive care syndrome (PICS) health domains with changes in health-related quality of life (HRQoL) following ICU admission.

Design: A longitudinal prospective multicenter cohort study.

Setting/patients: Patients ( n = 4092) from seven Dutch ICUs.

Interventions: None.

Measurements and main results: At ICU admission, 3 and 12 months post-ICU, patients completed validated questionnaires regarding physical health problems, cognitive health problems, mental health problems, and HRQoL. Composite scores were created for the physical health domain (physical problems and fatigue) and mental health domain (anxiety, depression, and post-traumatic stress disorder). Adjusted multivariable linear regression analyses were performed, including covariables (e.g., patient characteristics, disease severity, pre-ICU HRQoL, etc.) to explore associations between the physical, cognitive, and mental health domains of PICS and changes in HRQoL at 3 and 12 months post-ICU. At 3 months ( n = 3368), physical health problems (β = -0.04 [95% CI, -0.06 to 0.02]; p < 0.001), cognitive health problems (β = -0.05 [95% CI, -0.09 to -0.02]; p < 0.001), and mental health problems (β = -0.08 [95% CI, -0.10 to -0.05]; p < 0.001) were negatively associated with changes in HRQoL. Also, at 12 months ( n = 2950), physical health problems (β = -0.06 [95% CI, -0.08 to -0.03]; p < 0.001), cognitive health problems (β = -0.04 [95% CI, -0.08 to -0.01]; p < 0.015), and mental health problems (β = -0.06 [95% CI, -0.08 to -0.03]; p < 0.001) were negatively associated with changes in HRQoL.

Conclusions: PICS symptoms in the physical, cognitive, and mental domains are all negatively associated with changes in HRQoL at 3 and 12 months post-ICU. At 3 months, PICS symptoms in the mental domain seem to have the largest negative associations. At 12 months, the associations of PICS in the mental and physical domains are the same. This implies that daily ICU care and follow-up care should focus on preventing and mitigating health problems across all three PICS domains to prevent a decrease in HRQoL.

Trial registration: ClinicalTrials.gov NCT03246334.

PubMed Disclaimer

Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flowchart of study inclusions.
Figure 2.
Figure 2.
Mean baseline, 3 mo, and 12 mo health-related quality of life (HRQoL).
Figure 3.
Figure 3.
Mean changes between baseline and 3 mo and baseline and 12 mo health-related quality of life (HRQoL).
See this image and copyright information in PMC

References

    1. Zimmerman JE, Kramer AA, Knaus WA: Changes in hospital mortality for United States intensive care unit admissions from 1988 to 2012. Crit Care 2013; 17:R81–R89 - PMC - PubMed
    1. Iwashyna TJ, Cooke CR, Wunsch H, et al. : Population burden of long-term survivorship after severe sepsis in older Americans. J Am Geriatr Soc 2012; 60:1070–1077 - PMC - PubMed
    1. Harvey MA, Davidson JE: Postintensive care syndrome: Right care, right now…and later. Crit Care Med 2016; 44:381–385 - PubMed
    1. Silver GA: Paul Anthony Lembcke, MD, MPH: A pioneer in medical care evaluation. Am J Public Health 1990; 80:342–348 - PMC - PubMed
    1. Ullman AJ, Aitken LM, Rattray J, et al. : Diaries for recovery from critical illness. Cochrane Database Syst Rev 2014; 2014:CD010468. - PMC - PubMed

Publication types

Supplementary concepts

Associated data