Instruments to assess post-intensive care syndrome assessment: a scoping review and modified Delphi method study

Abstract

Background The assessment of post-intensive care syndrome (PICS) is challenging due to the numerous types of instruments. We herein attempted to identify and propose recommendations for instruments to assess PICS in intensive care unit (ICU) survivors. Methods We conducted a scoping review to identify PICS follow-up studies at and after hospital discharge between 2014 and 2022. Assessment instruments used more than two times were included in the modified Delphi consensus process. A modified Delphi meeting was conducted three times by the PICS committee of the Japanese Society of Intensive Care Medicine, and each score was rated as not important (score: 1–3), important, but not critical (4–6), and critical (7–9). We included instruments with ≥ 70% of respondents rating critical and ≤ 15% of respondents rating not important. Results In total, 6972 records were identified in this scoping review, and 754 studies were included in the analysis. After data extraction, 107 PICS assessment instruments were identified. The modified Delphi meeting reached 20 PICS assessment instrument recommendations: (1) in the physical domain: the 6-min walk test, MRC score, and grip strength, (2) in cognition: MoCA, MMSE, and SMQ, (3) in mental health: HADS, IES-R, and PHQ-9, (4) in the activities of daily living: the Barthel Index, IADL, and FIM, (5) in quality of life: SF-36, SF-12, EQ-5D-5L, 3L, and VAS (6), in sleep and pain: PSQI and Brief Pain Inventory, respectively, and (7) in the PICS-family domain: SF-36, HADS, and IES-R. Conclusion Based on a scoping review and the modified Delphi method, 20 PICS assessment instruments are recommended to assess physical, cognitive, mental health, activities of daily living, quality of life, sleep, and pain in ICU survivors and their families.

Outcome, predictors and longitudinal trajectories of subjects with critical illness polyneuropathy and myopathy (CINAMOPS): study protocol of an observational cohort study in a clinical and post-clinical setting

“…These assessments were recently recommended to identify PICS. 31 Logistic regression analyses will be conducted to identify predictors for mental and cognitive impairments in the long term, whereby the independent variables are the HADS (cut-off >7 points) and the MoCA (cut-off <26 points for mild cognitive impairment). Dependent variables for mental and cognitive health include age, sex, delirium during ICU stay, previous mental health problems, duration of mechanical ventilation, multiple organ failure, primary disease and Comorbidity Index.…”

Post‐intensive care syndrome: Recent advances and future directions

“…In 2023, the Japanese Society of Intensive Care Medicine recommended 6‐min walk test, medical research council (MRC) score, and grip strength for physical functions, MoCA, Mini‐Mental State Examination (MMSE), and short memory questionnaire (SMQ) for cognitive function, HADS, IES‐R, and patient health questionnaire‐9 (PHQ‐9) for mental health, Barthel Index, Instrumental Activities of Daily Living (IADL), and Functional Independence Measure (FIM) for the activities of daily living, and Short Form‐36 (SF‐36), SF‐12, EQ‐5D‐5L, 3L, and VAS for quality of life. 70 The PICS assessment tools are summarized in Table 1 .…”

From the Intensive Care Unit to Recovery: Managing Post-intensive Care Syndrome in Critically Ill Patients

“…A recent study has discovered that often utilized tools for this purpose include the Hospital Anxiety and Depression Scale (HADS), Impact of Events Scale-Revised (IES-R), and the six-item Impact of Event Scale-6 (IES-6) [ 17 ]. However, by comparing all of the PICS assessment methods, it has been shown that the Montreal Cognitive Assessment (MoCA) achieved the highest score in terms of reliability and validity for assessing the cognitive function of patients after ICU admission [ 28 ]. A protocol was developed for a multicenter randomized controlled trial that aims to evaluate the effects of a post-ICU multidisciplinary follow-up on the quality of life [ 29 ].…”