Investigadora Responsable: Paula Repetto Lisboa
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Medical intensive care has improved dramatically in recent decades and mortality rates have declined; today, 70% to 80% of critically ill patients survive. However, intensive care unit (ICU) survivors are at high risk of death in the medium to long term and suffer significant sequelae. Several survivors have long-term sequelae after discharge from the ICU, which will impact their quality of life and pose difficulties in re- entering their lives. These conditions have been labeled Post Intensive Care Syndrome (PICS). PICS is a multifaceted disorder that affects many patients who survive critical illness and receive treatment in the ICU. PICS has been defined as a «new onset or worsening impairment(s) in physical, cognitive, and/or mental health that arises after ICU and persists after hospital discharge.» It is a complex condition that can persist for weeks, months or even years after the patient’s discharge from the ICU, impacting the quality of life of survivors and their families, with significant financial consequences for patients and their families and economic implications for society, as it is associated with increased utilization of healthcare services and potential disability among survivors. PICS encompasses various physical, cognitive and psychological symptoms and impairments that can lead to a decline in overall functional capacity and affect the ability to return to work, perform daily activities independently and engage in social interactions. Over the past decade, we have learned much about PICS, particularly the conditions associated with this syndrome, and have identified some risk factors corresponding to sociodemographic conditions. In a few studies, researchers have identified some psychosocial conditions that may also explain PICS. These findings have attracted the attention of some researchers who have proposed that these factors correspond to social determinants of health. Following this framework, we can contribute to our understanding of the trajectories and outcomes of PICS.

Accordingly, this study aims to examine the trajectories of PICS among ICU survivors and the role of social determinants of health, such as sociodemographic factors, social support, loneliness, perceived social position, and previous health conditions, among other factors, combined with the role of biomarkers and ICU treatments.

We will conduct a longitudinal cohort study with a sample of 400 patients from 5 different ICUs in Chile who received critical care and will be followed up to one year post ICU discharge. They will be evaluated using different measures, including sociodemographic factors, ICU treatment, psychosocial factors, biomarkers, and PICS symptoms, among other variables. The longitudinal approach will allow us to explore different symptom/recovery trajectories among participants and examine the role of social determinants in these outcomes. We will use latent class analysis to identify these trajectories and the role of social determinants. We will also identify symptom clusters and characterize each cluster. We will also include biomarkers as other factors that explain these clusters and trajectories.

We hope these results will contribute to our understanding of PICS and provide information to design more effective interventions to prevent PICS and support the recovery process among critical care survivors.