Approved research

Understanding the social outcomes of survivors of critical illness: a cross sectional population study of UK Biobank participants

Lay summary

Rationale Intensive Care Unit patients are the sickest patients in the hospital. Many will unfortunately not survive. We know from previous research that the patients who do survive can have problems, which can be physical and emotional in nature. As a result, this patient group have frequent interactions with the NHS in the year following critical care discharge, including increased readmissions to hospital. Most research to date has looked at the medical reasons for these problems. We aim to develop a proactive intervention, pre-hospital discharge, to reduce readmission to acute care following critical illness. We will utilise the learning from this study to inform the different facets of this complex intervention. Aim The aim of this project is to understand if there are also social reasons for frequent readmissions to the hospital environment following critical illness. This will help inform the development of clinical interventions to support this patient group more effectively. Project Duration We have asked for access to this data for two years to allow us to understand the challenges this patient group have. We do not intend to follow-up any Biobank patients and we are not requesting blood samples. Public Health Impact 60% of patients discharged from critical care will be readmitted to hospital as an emergency with 90 days. This can cause stress for patients and their families, but also causes extra strain for the Health Service. This project will help understand how we can better support this vulnerable patient group. The research and clinical group involved in this project aim to create an intervention, informed from the results of this work, for patient and health service benefit.

Current Scope:

Research Questions

1. Do patients have increased social care requirements in the year following critical care discharge?
2. Does the housing status of critically ill patients impact healthcare utilisation in the year following critical care discharge?
3. Do critically ill patients have an increased number of interactions with their primary care provider in the year following critical care discharge, compared to the year preceding critical care admission?
4. Do mental health issues in critical care survivors lead to an increase in acute care readmissions in the year following critical care discharge?
5. Are physical, social, emotional and cognitive outcomes different between ICU and non ICU patients?

Research Aims

1. Identify social factors associated with increased healthcare utilisation following critical illness.
2. Determine the impact of mental health and emotional problems on healthcare utilisation. 
3. Define primary care interactions in the year following critical care discharge.
4. Examine physical, social, cognitive and emotional outcomes in the ICU cohort compared to and non-ICU cohort. 

Extended Scope

During our initial analysis we have noticed a significant proportion of the critical care group have a cancer diagnosis.  Previous evidence suggests that caner patients who experiences critical illness have a different trajectory to other critically ill patients. We therefore intend to :

1. Describe the profile of critically ill cancer patients in the UK Biobank, including post hospital outcome and different facets of the recovery pathway. 
2. We will compare this critically ill cancer group to a matched, non-critically ill group derived from the UK Biobank.  

3.  Examine the subsequent impact of critical illness on cancer progression and treatment.