What socioeconomic disadvantage means for critical illness recovery, clinical care, and research

Critical illness survivors are part of a vulnerable group. This growing population is at increased risk of long-term deficits, including all-cause survival, respiratory disease, cognitive functioning, mood, hospital readmissions, and physical function. Together, these impairments typify the post-intensive care syndrome (PICS). PICS symptoms related to physical disability are a particular source of angst and frustration, as physical dependence, mobility, the ability to perform activities of daily living (ADLs), the subjective feeling of weakness, and the ability to participate in hobbies are all core themes associated with patient’s satisfaction with life after critical illness. As this population of survivors increases, critical care clinicians are challenged to consider and try to improve outcomes long after patients leave the ICU. It is therefore crucial to identify patients at greatest risk of disability following their experience of critical illness. Doing so not only helps us identify patients most likely to benefit from interventions targeting optimal recovery but also helps us identify mediating factors that may partially explain disability, enabling precision in defining interventional targets.

Christopher F Chesley, Meghan B Lane-Fall