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Chapter 12 - Prognostication in Post-Intensive Care Syndrome

from Part I - Disease-Specific Prognostication

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 first intensive care units (ICUs) were established in the 1950s in the wake of a pandemic in order to rescue patients with respiratory failure from certain death, launching an entirely new field referred to today as critical care medicine.[1] The mortality associated with critical illness has improved substantially over the decades,[2,3] and long-term patient- and family-centered outcomes have emerged as important new targets for intervention. The post-intensive care syndrome (PICS) was defined in 2012 [2] as a constellation of cognitive, mental health, or physical impairments that occur after treatment in the ICU and persist well beyond discharge (Figure 12.1). A key feature of PICS is that these symptoms lead to a quality of life that is worse than expected based on the patient’s initial acute illness.[2,4] PICS may be overlooked during or shortly after hospital discharge, when success means simply surviving a critical illness, but these symptoms may result in substantial long-term disability months or even years later in one-half or more patients with critical illness.[5]

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Publisher: Cambridge University Press
Print publication year: 2024

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