Long term outcomes following critical care hospital admission: a prospective cohort study of UK Biobank participants

McPeake, J. , Iwashyna, T. J., Henderson, P., Leyland, A. H. , Mackay, D. , Quasim, T. , Walters, M. , Harhay, M. and Shaw, M. (2021) Long term outcomes following critical care hospital admission: a prospective cohort study of UK Biobank participants. Lancet Regional Health - Europe, 6, 100121. (doi: 10.1016/j.lanepe.2021.100121)

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Abstract

Background: This study aimed to understand the impact of a critical care admission on long-term outcomes, compared to other hospitalised patients without a critical care encounter. A secondary aim was to examine the interrelationship between emotional, physical, and social problems during recovery. Methods: We utilised data from the UK Biobank, an on-going, prospective population-based cohort study. We employed propensity score matching to assess differences in outcomes between patients with a critical care encounter and patients admitted to the hospital (first admission to hospital available) without critical care. Structural equation modelling was used to analyse emotional, physical and social outcomes following critical illness and the relationships between these health domains. Findings: Data from 1,618 patients were analysed. The median time to follow-up in the critical care cohort was 4427 days (IQR:788–6146) vs 4516 days (IQR: 811–6369) in the non-critical care, hospitalised cohort. Across the two time periods assessed (pre and post 2000), patients exposed to critical care were more likely to experience mental health issues such as depression (p < 0.01) and social isolation (p = 0.01) following discharge from hospital. The critical care cohort were also more likely to have social problems such as the requirement for government funded welfare support (p = 0.02). In the critical care cohort, social and emotional health were closely correlated (p < 0.001, 95% CI:0.33–0.54). The nature of physical problems changed over time; pre-2000 there was a significant difference between the critical and non-critical care in physical outcomes following discharge from hospital, however, there was no difference detected between the two cohorts post-2000. Interpretation: This cohort study has demonstrated that survivors of critical illness have different psycho-social outcomes to matched patients, hospitalised without a critical care encounter.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Quasim, Professor Tara and Mackay, Professor Daniel and Leyland, Professor Alastair and Henderson, Dr Philip and Shaw, Dr Martin and McPeake, Dr Jo and Walters, Professor Matthew
Authors: McPeake, J., Iwashyna, T. J., Henderson, P., Leyland, A. H., Mackay, D., Quasim, T., Walters, M., Harhay, M., and Shaw, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:Lancet Regional Health - Europe
Publisher:Elsevier
ISSN:2666-7762
ISSN (Online):2666-7762
Published Online:15 June 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Lancet Regional Health - Europe 6: 100121
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
307748Improving health and social care integration delivery in the acute care environmentJoanne McPeakeUniversity of Cambridge (HEI-CAMB)RG88620HW - MRC/CSO Social and Public Health Sciences Unit
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
Office of the Chief Scientific Adviser (CSO)SPHSU13