title: Feasibility of Post-Intensive Care Unit Clinics: an observational cohort study of two different approaches.
abstract: BACKGROUND
  Post-ICU clinics have been advocated to reduce long-term physical and psychological impairments among ICU survivors. A format for optimal structure, timing, and care content has not yet been established. We developed and implemented two post-ICU clinics in different hospital settings and evaluated the feasibility.
  
  
  METHODS
  In this prospective cohort study ICU-survivors of a university hospital (AMC) and a general hospital (TG), who were mechanically ventilated ≥ 2 days and discharged to their homes, were invited to the post-ICU clinic one month after hospital discharge (AMC) or three months after ICU discharge (TG). Feasibility was evaluated as 1) the number of eligible ICU-survivors and the proportion that attended; 2) the prevalence of ICU-related abnormalities, that required referral for further treatment; and 3) patient satisfaction.
  
  
  RESULTS
  Forty-five of 629 AMC-patients and 70 of 142 TG-patients were eligible for the post-ICU clinic. Of these, 49% and 67% respectively, visited the outpatient clinic (P=0.026). The majority of all screened patients had functional restrictions, and 68% required referral for further diagnosis and treatment. Patient satisfaction was high.
  
  
  CONCLUSIONS
  This study provides valuable information to support the implementation of post-ICU clinics. The use of validated screening instruments facilitates the identification of patients with need for further treatment. Early in-hospital screening and recruiting patients at highest risk for adverse outcome could be a more targeted approach to achieve greater benefit.
authors.affiliation: Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands - d.s.dettling@amc.uva.nl.
authors.forename: D S
authors.initials: DS
authors.lastname: Dettling-Ihnenfeldt
authors.forename: A E
authors.initials: AE
authors.lastname: De Graaff
authors.forename: F
authors.initials: F
authors.lastname: Nollet
authors.forename: M
authors.initials: M
authors.lastname: Van Der Schaaf
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003422:Critical Care / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D006757:Hospital Units / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D011446:Prospective Studies; D012121:Respiration, Artificial