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Survivorship After Neurocritical Care: A Scoping Review of Outcomes Beyond Physical Status

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Abstract

Following intensive care unit hospitalization, survivors of acute neurological injury often experience debilitating short-term and long-term impairments. Although the physical/motor impairments experienced by survivors of acute neurological injury have been described extensively, fewer studies have examined cognitive, mental health, health-related quality of life (HRQoL), and employment outcomes. This scoping review describes the publication landscape beyond physical and/or motor sequelae in neurocritical care survivors. Databases were searched for terms related to critical illness, intensive care, and outcomes from January 1970 to March 2022. English-language studies of critically ill adults with a primary neurological diagnosis were included if they reported on at least one outcome of interest: cognition, mental health, HRQoL or employment. Data extraction was performed in duplicate for prespecified variables related to study outcomes. Of 16,036 abstracts screened, 74 citations were identified for inclusion. The studies encompassed seven worldwide regions and eight neurocritical diagnosis categories. Publications reporting outcomes of interest increased from 3 before the year 2000 to 71 after. Follow-up time points included ≤ 1 (n = 15 [20%] citations), 3 (n = 28 [38%]), 6 (n = 28 [38%]), and 12 (n = 21 [28%]) months and 1 to 5 (n = 19 [26%]) and > 5 years (n = 8 [11%]), with 28 (38%) citations evaluating outcomes at multiple time points. Sixty-six assessment tools were used to evaluate the four outcomes of interest: 22 evaluating HRQoL (56 [76%] citations), 21 evaluating cognition (20 [27%] citations), 21 evaluating mental health (18 [24%] citations), and 2 evaluating employment (9 [12%] citations). This scoping review aimed to better understand the literature landscape regarding nonphysical outcomes in survivors of neurocritical care. Although a rising number of publications highlight growing awareness, future efforts are needed to improve study consistency and comparability and characterize outcomes in a disease-specific manner, including outlining of a minimum core outcomes set and associated assessment tools.

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Acknowledgements

The authors would like to acknowledge Karen Hesket, librarian and subject specialist for medicine at University of California, San Diego, for her assistance in the 2021 updated literature search and in obtaining full-text articles for review.

Funding

Dr. LaBuzetta acknowledges support by the National Institutes of Health (UL1TR001442, K23 AG080023). Dr. Kamdar is supported by a Paul B. Beeson Career Development Award through the National Institutes of Health/National Institute on Aging (K76 AG059936). Dr. Needham acknowledges funding from the National Institutes of Health/National Heart, Lung, and Blood Institute (R24HL111895).

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Authors and Affiliations

  1. Division of Neurocritical Care, Department of Neurosciences, University of California, San Diego Health, 9444 Medical Center Dr., East Campus Office Building 3-028, La Jolla, CA, 92037-7740, USA

    Jamie Nicole LaBuzetta, Dale N. Bongbong, Aaron Trando, Nicholas Ibrahim & Brandon Yip

  2. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California, San Diego Health, La Jolla, CA, USA

    Eric Mlodzinski, Richa Sheth, Atul Malhotra & Biren B. Kamdar

  3. Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA

    Victor D. Dinglas & Dale M. Needham

  4. Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, USA

    Victor D. Dinglas & Dale M. Needham

  5. Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA

    Dale M. Needham

Authors
  1. Jamie Nicole LaBuzetta
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  2. Dale N. Bongbong
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  11. Biren B. Kamdar
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Contributions

JNL, AM, VDD, DMN, BBK: Study design; JNL, DNB, AT, NI, BY, VDD: Abstract Screening; JNL, DNB, EM, RS, AT, NI, BY: Data extraction; JNL, DNB, BBK: Data analysis and interpretation of data; JNL, DNB, EM, RS, AT, NI, BY, AM, VDD, DMN, BBK: Manuscript writing and revisions; DMN, BBK: Supervision.

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Correspondence to Jamie Nicole LaBuzetta.

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LaBuzetta, J.N., Bongbong, D.N., Mlodzinski, E. et al. Survivorship After Neurocritical Care: A Scoping Review of Outcomes Beyond Physical Status. Neurocrit Care (2024). https://doi.org/10.1007/s12028-024-01965-9

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