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Chapter 19 - Prognostication in Chronic Critical Illness: Frailty, Geriatrics, Prior Severe Neurological Comorbidities

from Part II - Other Topics in Neuroprognostication

Published online by Cambridge University Press:  14 November 2024

David M. Greer
Affiliation:
Boston University School of Medicine and Boston Medical Center
Neha S. Dangayach
Affiliation:
Icahn School of Medicine at Mount Sinai and Mount Sinai Health System
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Summary

The advancement of medical science over the past several decades, while increasing the ability to preserve life among patients who are critically ill, has led to a new and increasing problem of patients who fail to recover full function. Hospitalized patients can be intensive care-dependent, such that they are unable to survive without receiving critical care, for more than a few days. Such patients have been described in the literature as having chronic critical illness,[1–6] persistently critically ill,[7,8] chronically medically complex,[9] requiring prolonged mechanical ventilation,[10–13] or long-stay patients.[14–16] The term “chronically critically ill” was introduced by Girard and Raffin in 1985.[17] They studied patients who survived an initial episode of critical illness but remained dependent on intensive care without recovering. Patients with chronic critical illness are an identifiable group of intensive care unit (ICU) patients with definable characteristics, have substantial stress associated with their care, and have poor perceived long-term outcomes.

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Publisher: Cambridge University Press
Print publication year: 2024

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