Predictors of return to work in survivors of critical illness

Carol L Hodgson; Kimberley J Haines; Michael Bailey; Jonathan Barrett; Rinaldo Bellomo; Tracey Bucknall; Belinda J Gabbe; Alisa M Higgins; Theodore J Iwashyna; Julian Hunt-Smith; Lynne J Murray; Paul S Myles; Jennie Ponsford; David Pilcher; Andrew A Udy; Craig Walker; Meredith Young; D J Jamie Cooper; ICU-Recovery Investigators

doi:10.1016/j.jcrc.2018.08.005

Predictors of return to work in survivors of critical illness

J Crit Care. 2018 Dec:48:21-25. doi: 10.1016/j.jcrc.2018.08.005. Epub 2018 Aug 13.

Authors

Carol L Hodgson¹, Kimberley J Haines², Michael Bailey³, Jonathan Barrett⁴, Rinaldo Bellomo⁵, Tracey Bucknall⁶, Belinda J Gabbe⁷, Alisa M Higgins³, Theodore J Iwashyna⁸, Julian Hunt-Smith⁹, Lynne J Murray³, Paul S Myles¹⁰, Jennie Ponsford¹¹, David Pilcher¹², Andrew A Udy¹², Craig Walker¹³, Meredith Young¹², D J Jamie Cooper¹⁴; ICU-Recovery Investigators

Affiliations

¹ Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; The Alfred Hospital, PO Box 315, Prahran, VIC 3181, Australia; Monash Partners Advanced Health Research and Translation Centre, Locked Bag 29, Clayton, VIC 3168, Australia. Electronic address: carol.hodgson@monash.edu.
² Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; Western Health, PO Box 294, St Albans, VIC 3021, Australia.
³ Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia.
⁴ Monash Partners Advanced Health Research and Translation Centre, Locked Bag 29, Clayton, VIC 3168, Australia; Epworth Health, 89 Bridge Road, Richmond, VIC 3121, Australia.
⁵ Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; Austin Health, PO Box 5555, Heidelberg, VIC 3084, Australia.
⁶ The Alfred Hospital, PO Box 315, Prahran, VIC 3181, Australia; Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
⁷ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; Farr Institute, Swansea University Medical School, Swansea University, UK.
⁸ Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; University of Michigan, MI, USA.
⁹ Epworth Health, 89 Bridge Road, Richmond, VIC 3121, Australia.
¹⁰ The Alfred Hospital, PO Box 315, Prahran, VIC 3181, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; Monash Partners Advanced Health Research and Translation Centre, Locked Bag 29, Clayton, VIC 3168, Australia.
¹¹ Monash Partners Advanced Health Research and Translation Centre, Locked Bag 29, Clayton, VIC 3168, Australia.
¹² Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; The Alfred Hospital, PO Box 315, Prahran, VIC 3181, Australia.
¹³ Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia.
¹⁴ Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; The Alfred Hospital, PO Box 315, Prahran, VIC 3181, Australia; Monash Partners Advanced Health Research and Translation Centre, Locked Bag 29, Clayton, VIC 3168, Australia.

PMID: 30138904
DOI: 10.1016/j.jcrc.2018.08.005

Abstract

Purpose: To determine predictors of inability to return to work due to health six-months after intensive care admission; and compare functional recovery between patients who had not returned to work and employed patients.

Methods: Participants were working adults admitted to ICU who received >24 h of mechanical ventilation. Outcomes included inability to return to work due to health at six-months post-ICU admission, disability, health status, anxiety, depression and post-traumatic stress.

Results: Of 107 patients, 31 (29%) were unable to return to work due to health at six-months after ICU admission. Predictors of inability to return to work included longer hospital stay (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02-1.08; P = .004); lower Glasgow Coma Scale (GCS) at admission (OR, 0.86; CI, 0.75-0.99; P = .03); and admission due to major trauma (OR, 8.83; CI, 2.57-30.38; P < .001). Compared to employed patients, those who had not returned to work reported higher levels of disability and psychological distress, and poorer health-related quality of life.

Conclusion: Major trauma, lower GCS and increased hospital length of stay predicted inability to return to work due to health at six-months post-ICU admission. Compared to employed patients, those who had not returned to work reported poorer functional recovery.

Keywords: Disability; Intensive care; Long-term outcomes; Mechanical ventilation; Psychological outcomes; Return to work.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Anxiety
Critical Illness / economics
Critical Illness / psychology
Critical Illness / rehabilitation*
Depression
Disabled Persons
Female
Health Status
Humans
Male
Middle Aged
Prospective Studies
Return to Work* / economics
Return to Work* / psychology
Return to Work* / statistics & numerical data
Survivors* / psychology
Survivors* / statistics & numerical data