This prospective observational study aims to describe the outcome for patients with persistent or chronic critical illness treated at Remeo, a clinic specialized for patients in need of prolonged intensive care and intensive care rehabilitation in Sweden. Patients' disease characteristics and the treatment in multidisciplinary patient centered teams for intensive care, weaning from mechanical ventilation and simultaneous rehabilitation will be described. Patients will be followed one year after discharge to document health related quality of life, physical function, frailty, mental illness and used health care resources.
Study Type
OBSERVATIONAL
Enrollment
250
Remeo
Sköndal, Stockholm County, Sweden
Change in mechanical ventilation status
Time (Days) from admittance to unit until weaned from mechanical ventilation
Time frame: Assessed at admittance and immediately after discharge from unit
Change in tracheostomy status
Time (Days) from admittance to unit until decannulation
Time frame: Assessed at admittance and immediately after discharge from unit
In-patient mortality and mortality
Mortality during care at unit
Time frame: Assessed immediately after discharge from unit
Mortality during 12 months follow-up after discharge
Mortality during 12 months follow-up after discharge
Time frame: Assessed 12 months after discharge
Health related quality of Life assessed by the Rand 36-Item Health Survey (RAND36)
RAND36 (scale 0-100, higher value better) questionnaire
Time frame: 3 months after discharge from unit
Health related quality of Life assessed by the Rand 36-Item Health Survey (RAND36)
RAND36 (scale 0-100, higher value better) questionnaire
Time frame: 6 months after discharge from unit
Health related quality of Life assessed by the Rand 36-Item Health Survey (RAND36)
RAND36 (scale 0-100, higher value better) questionnaire
Time frame: 12 months after discharge from unit
Health related quality of Life assessed by EuroQoL 5-dimension 5-level (EQ-5D-5L)
EQ-5D-5L questionnaire
Time frame: 3 months after discharge from unit
Health related quality of Life assessed by EuroQoL 5-dimension 5-level (EQ-5D-5L)
EQ-5D-5L questionnaire
Time frame: 6 months after discharge from unit
Health related quality of Life assessed by EuroQoL 5-dimension 5-level (EQ-5D-5L)
EQ-5D-5L questionnaire
Time frame: 12 months after discharge from unit
Independence in activities of daily living assessed by Katz Index of Independence in Activities of Daily Living (Katz ADL)
Katz ADL (scale 0-6, higher value better)
Time frame: At admission to unit
Independence in activities of daily living assessed by Katz Index of Independence in Activities of Daily Living (Katz ADL)
Katz ADL (scale 0-6, higher value better)
Time frame: Immediately before decannulation
Independence in activities of daily living assessed by Katz Index of Independence in Activities of Daily Living (Katz ADL)
Katz ADL (scale 0-6, higher value better)
Time frame: Immediately before discharge from unit
Independence in activities of daily living assessed by Katz Index of Independence in Activities of Daily Living (Katz ADL)
Katz ADL (scale 0-6, higher value better)
Time frame: 6 months after discharge from unit
Independence in activities of daily living assessed by Katz Index of Independence in Activities of Daily Living (Katz ADL)
Katz ADL (scale 0-6, higher value better)
Time frame: 12 months after discharge from unit
Symptoms of depression as assessed by the Patient Health Questionnaire-9 (PHQ-9)
PHQ-9, a patient related outcome questionnaire, scale 0-27, higher value indicating more severe symptoms
Time frame: 3 months after discharge from unit
Symptoms of depression as assessed by the Patient Health Questionnaire-9 (PHQ-9)
PHQ-9, a patient related outcome questionnaire, scale 0-27, higher value indicating more severe symptoms
Time frame: 6 months after discharge from unit
Symptoms of depression as assessed by the Patient Health Questionnaire-9 (PHQ-9)
PHQ-9, a patient related outcome questionnaire, scale 0-27, higher value indicating more severe symptoms
Time frame: 12 months after discharge from unit
Symptoms of generalized anxiety as assessed by the General anxiety disorder 7 (GAD-7) questionnaire
GAD-7, a patient related outcome questionnaire, scale 0-21, higher value indicating more severe symptoms
Time frame: 3 months after discharge from unit
Symptoms of generalized anxiety as assessed by the General anxiety disorder 7 (GAD-7) questionnaire
GAD-7, a patient related outcome questionnaire, scale 0-21, higher value indicating more severe symptoms
Time frame: 6 months after discharge
Symptoms of generalized anxiety as assessed by the General anxiety disorder 7 (GAD-7) questionnaire
GAD-7, a patient related outcome questionnaire, scale 0-21, higher value indicating more severe symptoms
Time frame: 12 months after discharge from unit
Frailty as assessed by the Clinical frailty scale (CFS)
The Clinical frailty scale has 9 levels from very fit to terminally ill (1-9, lower value indicate better outcome)
Time frame: At admission to unit
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Frailty as assessed by the Clinical frailty scale (CFS)
The Clinical frailty scale has 9 levels from very fit to terminally ill (1-9, lower value indicate better outcome)
Time frame: Immediately before discharge from unit
Frailty as assessed by the Clinical frailty scale (CFS)
The Clinical frailty scale has 9 levels from very fit to terminally ill (1-9, lower value indicate better outcome)
Time frame: At 6 months after discharge from unit
Frailty as assessed by the Clinical frailty scale (CFS)
The Clinical frailty scale has 9 levels from very fit to terminally ill (1-9, lower value indicate better outcome)
Time frame: At 12 months after discharge from unit
Physical status as assessed by the 6 minutes walk test
The 6 min walk test evaluated by a physiotherapist (longer distance (meters) better outcome)
Time frame: At admission to unit
Physical status as assessed by the 6 minutes walk test
The 6 min walk test evaluated by a physiotherapist (longer distance (meters) better outcome)
Time frame: Immediately before decannulation
Physical status as assessed by the 6 minutes walk test
The 6 min walk test evaluated by a physiotherapist (longer distance (meters) better outcome)
Time frame: Immediately before discharge from unit
Physical status as assessed by the 6 minutes walk test
The 6 min walk test evaluated by a physiotherapist (longer distance (meters) better outcome)
Time frame: 6 months after discharge from unit
Physical status as assessed by the 6 minutes walk test
The 6 min walk test evaluated by a physiotherapist (longer distance (meters) better outcome)
Time frame: 12 months after discharge from unit
Cognitive status as assessed by the Montreal cognitive assessment (MoCa) test
Performed by an occupational therapist. The MoCa test score scale is 0-30 Points, higher value indicate better outcome
Time frame: At admission to unit
Cognitive status as assessed by the Montreal cognitive assessment (MoCa) test
Performed by an occupational therapist. The MoCa test score scale is 0-30 Points, higher value indicate better outcome
Time frame: Immediately before decannulation
Cognitive status as assessed by the Montreal cognitive assessment (MoCa) test
Performed by an occupational therapist. The MoCa test score scale is 0-30 Points, higher value indicate better outcome
Time frame: Immediately before discharge from unit
Physical status as assessed by the Chelsea Critical Care Physical Assessment tool (CPAx).
CPAx performed by a physiotherapist (scale 0-50 Points, higher value indicate better outcome)
Time frame: At admission to unit
Physical status as assessed by the Chelsea Critical Care Physical Assessment tool (CPAx).
CPAx performed by a physiotherapist (scale 0-50 Points, higher value indicate better outcome)
Time frame: Immediately after decannulation
Physical status as assessed by the Chelsea Critical Care Physical Assessment tool (CPAx).
CPAx performed by a physiotherapist (scale 0-50 Points, higher value indicate better outcome)
Time frame: Immediately before discharge from unit
Physical status as assessed by the Chelsea Critical Care Physical Assessment tool (CPAx).
CPAx performed by a physiotherapist (scale 0-50 Points, higher value indicate better outcome)
Time frame: 6 months after discharge from unit
Physical status as assessed by the Chelsea Critical Care Physical Assessment tool (CPAx).
CPAx performed by a physiotherapist (scale 0-50 Points, higher value indicate better outcome)
Time frame: 12 months after discharge from unit
Swallowing function and possibility of oral intake
Using the Functional oral intake scale (FOIS)
Time frame: At admission to unit
Swallowing function and possibility of oral intake
Using the Functional oral intake scale (FOIS)
Time frame: Immediately before decannulation
Swallowing function and possibility of oral intake
Using the Functional oral intake scale (FOIS), seven different levels 1-7, higher level indicate better function
Time frame: Immediately before discharge from unit
Swallowing function and possibility of oral intake
Using the Functional oral intake scale (FOIS), seven different levels 1-7, higher level indicate better function
Time frame: At at 6 months after discharge from unit
Swallowing function and possibility of oral intake
Using the Functional oral intake scale (FOIS), seven different levels 1-7, higher level indicate better function
Time frame: At at 12 months after discharge from unit
Inflammatory status relative to outcome
HMGB1 and routine inflammation markers' effect on outcome measures
Time frame: Through study completion, an average of 14 months