Long-term outcomes after critical illness: With all thy getting, get understanding

摘要

Long-term outcomes after stay in the ICU have been studied for many years, presumably first because clinicians recognized that ICU stay was only a small portion of total hospital care and that morbidity and mortality continued to accrue after both ICU and hospital discharge. The earliest studies were small, single-center efforts to better understand what happened to patients in the hospital wards after ICU discharge. With time, these efforts extended further beyond the hospital and over ever-expanding lengths of time (1). Large-scale epidemiological studies have lagged behind, often focusing on ICU or hospital mortality (2,3), evolving with increasing recognition that long-term outcomes are more clinically relevant and probably of greater interest to patients and families. With this longer lens, we have discovered tremendous variability in reporting methods (1) and greater uncertainty about whether ICU stay is a true predictor of worse long-term outcomes (4,5). This is important because if severity of illness is truly associated with long-term mortality (6), then any episode of critical illness may shorten life expectancy.