15 GENERAL INTRODUCTION 1 Part 1: Identifying limited recovery Chapter 2 describes a retrospective study on recovery of physical functioning in the first year after ICU-admission. In this chapter, impaired physical functioning at the outpatient clinic visit is proposed as a marker for long-term non-recovery. Chapter 3 introduces a new concept of mental frailty after ICU-discharge. In this chapter, the prevalence of mental frailty and the consequences for ICU-survivors and their informal caretakers during recovery are determined. Chapter 4 discusses recovery in health-related quality of life, healthcare utilisation, and back to work practices of an intensive 1-year prospective cohort study. Part 2: Malnutrition and frailty in ICU-patients Chapter 5 presents the use of the bioimpedance (BIA)-derived phase angle -a proxy for malnutrition and physical frailty- as a marker for 1-year mortality. Chapter 6 discusses long-term dietary intake and nutritional practices during ICU-stay and the first year of ICU-recovery. Part 3: Improving recovery after critical illness Chapter 7 reports the findings of an extensive systematic review on the effect of dietary and exercise interventions on nutrition-related outcomes. Chapter 8 presents a user-centred Virtual Reality-exergame to improve physical recovery during and after ICU-stay. Chapter 9 elaborates on the main findings of this thesis. Furthermore, clinical implications, recommendations for research and future perspectives from the Frisian cohort initiative are shared.
RkJQdWJsaXNoZXIy MjY0ODMw