59 HRQOL, HEALTHCARE UTILISATION AND BACK-TO-WORK ACTIVITIES IN ICU-SURVIVORS 4 4.1 INTRODUCTION The primary aim of Intensive Care Unit (ICU)-treatment is to improve the chance of survival for critically ill patients. Over the last few decades, enhanced treatment options and advanced technologies have resulted in an increased number of ICU-survivors.1-3 Despite this success, evaluation of patient-centred outcomes, commonly assessed by HRQoL scores, has revealed substantial proportions of survivors experiencing persistent physical, mental, and cognitive health problems.3-5 Previous research in this population has indicated a large proportion of ICU-patients suffer from long-term limitations in physical functioning in the first year after admission.6 Therefore, using physical functioning as a marker for recovery in HRQoL may provide researchers and clinicians with more information on overall vulnerability in the post-ICU period. Although critical care research has embraced the need for more robust information regarding ICU-recovery, long-term follow-up of ICU-patients has been burdened with high loss to follow-up, heterogeneity of results, and a lack of uniform methodology. Further, assessing the impact of critical illness is complicated in the acute setting, in particular due to the lack of baseline information regarding preadmission health status. Additionally, there is a need for more evidence regarding the impact of long-term health problems on the ability to participate in work activities, as well as on healthcare utilisation. Information regarding healthcare utilisation is often predominantly focussed on the amount of hospital and ICU-readmissions.7 However, more in-depth information regarding the use of physical therapy, dietary consultations, and home care, among others, is limited. In this study, the primary aim was to prospectively confirm percentages of non-recovery (NR)-patients at twelvemonths after ICU-admission. Additionally, we aimed to obtain a highly detailed follow-up, including baseline HRQoL, the effect of NR on healthcare utilisation and back-to-work activities. 4.2 MATERIAL AND METHODS 4.2.1 Study design and population This prospective, single-centre, observational study was performed in a tertiary teaching hospital with a mixed ICU, located in Leeuwarden, the Netherlands. The ICU is an 18-bed mixed medical-surgical unit that admits close to 1500
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