April 24, 2026
3 min read
Key takeaways:
- Around 30% of ICU providers indicated that they would discuss post-intensive care syndrome with the patient/family more than one-half of the time.
- Remembrance of this dialogue was reported by 35.6% of patients.
There is room for improvement in discussing post-intensive care syndrome with ICU patients and their families, as ICU providers and patients had low awareness of this syndrome, according to survey findings published in CHEST.
“Our ICU patients experience challenges during their recovery, especially cognitive changes and mental health distress, that unfortunately come at a complete surprise to them,” Mark L. Rolfsen, MD, MSCI, clinical fellow in the division of allergy, pulmonary and critical care medicine at Vanderbilt University Medical Center, told Healio. “Short conversations or mention of resources (eg, icudelirium.org) can provide anticipatory guidance and potentially ameliorate this surprise.”
Researchers highlighted that 58.2% of ICU survivors wished there were more conversations about recovery prior to ICU discharge. Image: Adobe Stock
Using data from online surveys, Rolfsen and colleagues evaluated responses from 382 ICU health care providers at nine U.S. institutions (six academic, one nonacademic and two mixed academic and nonacademic) and 146 patients (median age, 56 years; 47.9% female; 93.8% white) who recently survived critical illness to determine the awareness level of post-intensive care syndrome (PICS) in both groups.
“There is plenty of research on PICS and long-term outcomes after critical illness, but whether this is actually being told to patients/families outside of research encounters was not well studied,” Rolfsen said.
Population characteristics
Among the surveyed ICU providers, most were registered nurses (RNs; 53.7%), followed by attending physicians (23.6%), advanced practice providers (APPs; 13.4%) and fellows (9.4%).
The surgical ICU and cardiovascular ICU were where the majority of ICU survivors surveyed had their most recent admission (each 41.1%). Fewer patients had been admitted to a medical ICU (14.4%), cardiac ICU (2.7%) and trauma ICU (0.7%).
Results
When asked if they had previously heard the term “post-intensive care syndrome,” 73.8% of providers had an affirmative response, whereas a smaller proportion of patients (16.6%) said they remembered being told the term, according to the study.
Notably, when broken down by provider role, researchers found that fellows and attending physicians had the highest proportion of individuals who heard the term (97.6%) while RNs had the lowest proportion (56%).
“We found that, despite sampling academic centers where PICS might be more discussed, only about half of bedside nurses had heard of the term,” Rolfsen told Healio. “We believe that improving nursing awareness of PICS and equipping them with the tools and confidence to discuss these possible outcomes with patients or families would be a valuable endeavor.”
In terms of provider confidence in communicating the likeliness of having new/worsening impairments after critical illness to patients and families, less than one-third (31.7%; RNs, 29.9%; APPs, 28%; fellows and attendings, 36%) said they felt “good” or “excellent.”
Additionally, the frequency of discussions with patients/families on the possibility of any new/worsening impairments after critical illness was low. With the context of “a patient who required mechanical ventilation and vasopressors with several days of delirium and who was expected to return home and potentially to full employment,” 29.9% of providers indicated that they would have this discussion with the patient/family more than one-half of the time.
On the patient side, researchers found that 35.6% reported remembering being told about the possibility of not returning to the same baseline function after critical illness.
Taking a closer look at the three domains of PICS, the domain with the highest proportion of providers reporting that they communicate it at least half the time was the physical domain (55.4%), followed by the cognitive domain (24.6%) and the mental health domain (22.8%).
Among patients, the domain with the highest proportion of individuals that remember being told about it was also the physical domain (40.3%), followed by the mental health domain (34.5%) and the cognitive domain (26.9%).
Lastly, researchers highlighted that 45.2% of patients expressed being surprised at how challenging recovery from critical illness has been, and 58.2% wished there were more conversations about recovery prior to ICU discharge.
“Families are crucial in receiving information for their loved ones who might have poor recollection of the ICU or even hospital admission (a noted limitation of our study),” Rolfsen told Healio. “Determining when and how to deliver information to families would be an important step forward.
“Additionally, hospitalists are pivotal in improving this communication gap and we hope to collaborate with them to improve patient-centered outcomes,” he said.
For more information:
Mark L. Rolfsen, MD, MSCI, can be reached at mark.l.rolfsen@vumc.org.
Perspective
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Margo A. Halm, PhD, RN, NEA-BC, FAAN
Disclosures: Halm reports no relevant financial disclosures.
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