Background
Methods
Study design
Scoping review
Data extraction and study selection in the scoping review
The Delphi consensus process
Results
Literature Search
Data extraction
Post-Intensive Care Syndrome categories | Frequency of use | Modified Delphi consensus process | |||||
---|---|---|---|---|---|---|---|
After hospital discharge | At hospital discharge | 1st average | 2nd average | 3rd average | 3rd ≤ 3 | 3rd ≥ 7 | |
Physical function | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
6-min walk test | 49 | 11 | 8.2 | 8.1 | 8.0 | 0 | 22 |
Pulmonary function tests (Spirometer, DLCO) | 39 | 2 | 6.0 | 5.6 | 5.6 | 2 | 7 |
Medical Research Council (MRC) score | 34 | 22 | 8.3 | 8.1 | 8.2 | 0 | 22 |
Grip strength | 34 | 20 | 8.0 | 7.8 | 7.8 | 0 | 20 |
Clinical Frailty Scale (CFS) | 16 | 3 | 7.0 | 6.8 | 6.6 | 0 | 12 |
Sit-to-stand test (30 s, 1 min) | 15 | 2 | 6.1 | 6.0 | 5.9 | 0 | 8 |
Short Physical Performance Battery (SPPB) | 14 | 4 | 6.5 | 6.2 | 6.1 | 1 | 11 |
4-m gait speed test | 8 | 0 | 5.6 | 5.3 | 5.2 | 0 | 1 |
Manual muscle test (MMT) | 6 | 2 | 6.1 | 5.5 | 5.5 | 1 | 4 |
MRC dyspnea scale | 6 | 2 | 5.2 | 4.7 | 4.7 | 3 | 1 |
Saint George’s Respiratory Questionnaire (SGRQ) | 6 | 0 | 4.0 | 3.3 | 3.4 | 12 | 0 |
Isometric Quadriceps Strength | 6 | 1 | 4.9 | 4.6 | 4.5 | 4 | 0 |
TUG (Timed Up and Go test) | 5 | 1 | 5.4 | 5.2 | 5.1 | 2 | 3 |
BERG balance test | 4 | 0 | 4.2 | 3.8 | 3.7 | 11 | 1 |
Physical Functional Status (PFS) | 4 | 0 | 4.5 | 4.2 | 4.1 | 4 | 0 |
Chelsea critical care Physical Assessment tool (CPAx) | 4 | 4 | 4.5 | 3.7 | 3.6 | 11 | 0 |
Borg Dyspnea Scale | 4 | 0 | 4.4 | 3.7 | 3.7 | 10 | 0 |
10-min walk test | 3 | 0 | 3.9 | 3.4 | 3.2 | 12 | 0 |
2-min walk test | 3 | 1 | 4.6 | 4.3 | 4.3 | 4 | 0 |
Fried Frailty Criteria | 3 | 0 | 4.7 | 4.0 | 4.0 | 5 | 0 |
Physical Functional test (PFIT) for the ICU | 1 | 8 | 4.2 | 3.5 | 3.6 | 11 | 0 |
Functional Status Score for the ICU (FSS-ICU) | 0 | 4 | 4.2 | 3.7 | 3.7 | 10 | 1 |
Functional Ambulation Categories (FACs) | 2 | 3 | 4.2 | 3.8 | 4.0 | 8 | 1 |
Cognitive function | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
Montreal Cognitive Assessment (MoCA) | 37 | 11 | 8.1 | 8.3 | 8.3 | 0 | 23 |
Mini-Mental State Examination (MMSE) | 36 | 16 | 8.1 | 8.1 | 8.0 | 0 | 23 |
Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) | 21 | 1 | 6.0 | 5.9 | 5.8 | 0 | 3 |
Trail Making Test A, B | 15 | 1 | 5.4 | 5.3 | 5.3 | 0 | 1 |
Telephone Interview for Cognitive Status (TICS) | 9 | 0 | 6.0 | 6.1 | 6.1 | 1 | 10 |
Short Memory Questionnaire (SMQ) | 7 | 2 | 6.7 | 6.8 | 7.3 | 0 | 21 |
Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) | 7 | 2 | 5.4 | 5.3 | 5.3 | 3 | 3 |
Cognitive Failures Questionnaire (CFQ) | 7 | 0 | 5.0 | 4.9 | 4.8 | 3 | 1 |
Cognitive and Affective Mindfulness Scale (CAMS) revised version | 5 | 0 | 4.3 | 4.1 | 4.1 | 6 | 1 |
Wechsler Adult Intelligence Scale (WAIS-IV) | 4 | 1 | 4.0 | 3.8 | 3.7 | 10 | 0 |
Healthy Aging Brain Care monitor self-report tool (HABC monitor) | 4 | 0 | 4.3 | 4.0 | 3.7 | 12 | 0 |
Rey Auditory-Verbal Learning Test (RAVLT) | 4 | 1 | 3.4 | 3.1 | 3.1 | 17 | 0 |
Cambridge Neuropsychological Test Automated Battery (CANTAB) | 3 | 0 | 4.4 | 4.0 | 4.0 | 7 | 0 |
Clinical Dementia Rating (CDR) | 3 | 0 | 4.2 | 3.7 | 3.9 | 7 | 0 |
Mental health | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
Hospital Anxiety and Depression Scale (HADS) | 155 | 31 | 8.8 | 8.8 | 8.9 | 0 | 23 |
Impact of Event Scale-Revised (IES-R) | 76 | 22 | 8.3 | 8.5 | 8.7 | 0 | 23 |
Patient Health Questionnaire-9 (PHQ-9) | 26 | 5 | 7.0 | 7.0 | 6.9 | 0 | 19 |
Post-traumatic Stress Scale 10 (PTSS-10) | 20 | 0 | 6.6 | 6.5 | 6.5 | 0 | 13 |
PTSD Checklist for DSM-5 (PCL-5) | 18 | 5 | 6.5 | 6.5 | 6.5 | 1 | 14 |
Beck Depression Inventory-II (BDI-II) | 16 | 0 | 5.2 | 5.1 | 5.2 | 2 | 1 |
Generalized Anxiety Disorder-7 (GAD-7) | 13 | 1 | 5.7 | 5.5 | 5.5 | 1 | 3 |
PTSD Checklist, Civilian version (PCL-C) | 12 | 0 | 5.5 | 5.3 | 5.3 | 1 | 2 |
Impact of Event Scale (IES) | 11 | 0 | 4.3 | 4.3 | 4.4 | 4 | 0 |
Post-Traumatic Stress Scale 14 (PTSS-14) | 11 | 0 | 5.0 | 5.2 | 5.0 | 2 | 1 |
PTSD Checklist-Specific (PCL-S) | 9 | 0 | 5.3 | 5.0 | 5.0 | 1 | 1 |
Impact of Event Scale-6 (IES-6) | 8 | 2 | 6.2 | 6.0 | 6.2 | 0 | 10 |
PHQ-2 | 7 | 2 | 5.2 | 4.9 | 4.9 | 4 | 2 |
Numerical Rating Scale (NRS)-Anxiety | 5 | 0 | 5.0 | 5.0 | 5.0 | 3 | 1 |
Depression Anxiety Stress Scale (DASS-21) | 5 | 4 | 4.9 | 4.8 | 4.8 | 3 | 0 |
State Trait Anxiety Inventory (STAI) | 5 | 0 | 4.1 | 4.1 | 4.0 | 6 | 0 |
Center for Epidemiological Studies-Depression Scale (CES-D) | 5 | 0 | 4.2 | 3.9 | 3.7 | 11 | 0 |
Visual Analog Scale (VAS) | 4 | 12 | 5.4 | 5.0 | 4.8 | 3 | 1 |
Brief COPE (Coping Orientation to Problems Experienced) Inventory | 4 | 0 | 4.1 | 3.9 | 3.9 | 9 | 0 |
Trauma Screening Questionnaire | 4 | 0 | 4.3 | 4.0 | 4.0 | 8 | 0 |
Major Depression Inventory (MDI) | 3 | 0 | 5.0 | 4.5 | 4.5 | 2 | 0 |
PHQ-8 | 3 | 0 | 5.3 | 4.9 | 5.0 | 2 | 2 |
PHQ-4 | 3 | 0 | 5.1 | 4.8 | 4.9 | 3 | 2 |
Davidson Trauma Scale (DTS) | 3 | 0 | 3.9 | 3.6 | 3.4 | 11 | 0 |
ADL | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
Barthel Index | 47 | 20 | 8.6 | 8.7 | 8.7 | 0 | 23 |
Instrumental Activities of Daily Living (IADL) | 25 | 0 | 7.7 | 7.6 | 7.6 | 0 | 20 |
Modified Rankin Scale (mRS) | 19 | 4 | 6.0 | 6.1 | 6.0 | 1 | 5 |
Katz Activities of Daily Living | 19 | 0 | 6.6 | 6.6 | 6.4 | 0 | 12 |
Functional Independence Measure (FIM) | 12 | 10 | 7.1 | 7.0 | 6.8 | 0 | 18 |
World Health Organization’s Disability Assessment Schedule (WHODAS 2.0) | 11 | 0 | 5.8 | 5.7 | 5.7 | 0 | 4 |
Glasgow Outcome Scale (GOS) | 9 | 0 | 4.7 | 4.7 | 4.7 | 2 | 0 |
GOS-E (GOS-Extended) | 9 | 0 | 4.7 | 4.4 | 4.3 | 1 | 0 |
Cerebral Performance Category (CPC) | 8 | 4 | 4.4 | 3.9 | 4.0 | 5 | 0 |
Functional Activities Questionnaire (FAQ) | 8 | 0 | 4.9 | 4.4 | 4.4 | 5 | 1 |
Functional Performance Inventory (FPI) | 4 | 0 | 4.0 | 3.4 | 3.3 | 16 | 0 |
Zubrod score | 3 | 0 | 3.9 | 3.6 | 3.5 | 10 | 0 |
Disability Rating Scale (DRS) | 3 | 0 | 3.8 | 3.6 | 3.5 | 11 | 0 |
QOL | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
Short Form-36 Including RAND-36 (SF-36) | 153 | 42 | 8.1 | 8.1 | 8.2 | 0 | 23 |
EuroQol-5Dimension-5Level (EQ-5D-5L) | 70 | 15 | 8.5 | 8.6 | 8.5 | 0 | 23 |
EuroQol-5Dimension-3Level (EQ-5D-3L) | 46 | 8 | 7.3 | 7.1 | 7.0 | 0 | 18 |
EuroQol-Visual Analog Scale (EQ-VAS) | 39 | 4 | 7.5 | 7.5 | 7.4 | 0 | 21 |
Short Form-12 (SF-12) | 26 | 1 | 6.8 | 6.7 | 7.3 | 0 | 21 |
World Health Organization Quality of Life (WHOQOL) | 5 | 0 | 5.2 | 5.0 | 5.1 | 3 | 3 |
Quality-Adjusted Life Year (QALY) | 4 | 0 | 4.6 | 4.3 | 4.3 | 6 | 0 |
Assessment of Quality of Life-4D (AQoL-4D) | 4 | 0 | 4.4 | 4.1 | 4.0 | 5 | 0 |
15D instrument | 3 | 0 | 4.3 | 4.0 | 4.0 | 6 | 0 |
Sleep | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
Pittsburgh Sleep Quality Index (PSQI) | 9 | 0 | 6.9 | 6.7 | 6.7 | 0 | 17 |
Insomnia severity index | 8 | 0 | 6.3 | 6.0 | 6.0 | 0 | 5 |
Actigraphy | 3 | 0 | 3.9 | 3.7 | 3.7 | 10 | 0 |
Pain | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
Brief Pain Inventory | 13 | 0 | 7.1 | 7.0 | 7.1 | 0 | 19 |
NRS | 5 | 2 | 6.7 | 6.3 | 6.6 | 0 | 14 |
VAS | 3 | 0 | 6.8 | 6.3 | 6.5 | 0 | 14 |
Graded Chronic Pain Scale (GCPS) | 3 | 0 | 5.0 | 4.7 | 4.8 | 3 | 2 |
Fatigue | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
Fatigue Severity Scale (FSS) | 3 | 0 | 5.9 | 5.3 | 5.6 | 0 | 4 |
Fatigue Assessment Scale (FAS) | 3 | 0 | 5.8 | 5.3 | 5.6 | 0 | 5 |
Others | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
Measure of Current Status part A (MOCS-A) | 4 | 0 | 4.0 | 3.6 | 3.6 | 12 | 0 |
General Self Efficacy (GSE) scale | 3 | 0 | 4.2 | 3.7 | 3.9 | 7 | 0 |
Family | (number) | (number) | (score) | (score) | (score) | (number) | (number) |
SF-36 | 47 | 0 | 7.7 | 7.9 | 8.0 | 0 | 22 |
HADS | 34 | 17 | 8.3 | 8.5 | 8.6 | 0 | 23 |
IES-R | 19 | 0 | 8.2 | 8.3 | 8.6 | 0 | 23 |
Family Satisfaction in the ICU (FS-ICU) | 10 | 1 | 6.3 | 6.4 | 6.4 | 0 | 13 |
PCL-S | 7 | 0 | 5.8 | 5.6 | 5.5 | 0 | 2 |
IES | 7 | 0 | 4.6 | 4.4 | 4.4 | 6 | 0 |
PCL-C | 5 | 0 | 5.2 | 5.2 | 5.1 | 3 | 1 |
PHQ-9 | 5 | 0 | 6.0 | 6.3 | 6.0 | 1 | 8 |
CES-D | 5 | 0 | 4.4 | 4.1 | 4.2 | 7 | 0 |
PSQI | 5 | 0 | 6.0 | 5.8 | 6.0 | 1 | 8 |
Quality of Death and Dying (QODD) | 3 | 0 | 4.5 | 4.4 | 4.4 | 2 | 0 |
PHQ-8 | 3 | 0 | 5.0 | 4.6 | 4.7 | 4 | 1 |
Zarit Burden Interview-12 items (Zarit-12) | 3 | 0 | 4.8 | 4.8 | 4.9 | 2 | 2 |
The Delphi consensus
Domain | Assessment instruments | Items | Score rage | Reliability | Validity | MICD | Features |
---|---|---|---|---|---|---|---|
Physical | 6-min walk test | 1 | – | 0.72–0.99 [19]a | 0.59 [20] | 10% [21] | The value depends on age, sex, body weight, and height |
MRC (Medical Research Council) score | 12 | 0–60 | 0.83–0.99 [22] | 0.64 [23] | – | Muscle strength by manual muscle strength at 12 points | |
Grip Strength | 1 | – | 0.87–0.92 [24] | 0.76 [25] | 5.7–12.5 [24] | Muscle strength by a grip dynamometer | |
Cognitive | Montreal Cognitive Assessment (MoCA) | 8 | 0–30 | 0.92 [26] | 0.87 [26] | 2 [27] | Visuospatial/executive, naming, memory, attention, language, abstraction, delayed recall, orientation |
Mini-Mental State Examination ( MMSE) | 11 | 0–30 | 0.56–0.93 [28] | 0.43–0.99 [29] | 1–3 [30]b | Registration, attention, calculation, recall, language, ability to follow simple commands, orientation | |
Short Memory Questionnaire ( SMQ) | 14 | 4–46 | – | – | – | Short-term memory, remote memory, cognition, orientation, calculation | |
Mental | Hospital Anxiety and Depression Scale (HADS) | 14 | 0–21 | 0.86–0.90 [31]c | 0.88–0.93 [32] | 1.5 [33]c | Anxiety/Depression |
Impact of Event Scale-Revised (IES-R) | 22 | 0–4 (average) | 0.86 [34] | – | 4.0 [35] | PTSD | |
Patient Health Questionnaire-9 (PHQ-9) | 9 | 0–27 | 0.84–0.89 [36] | 0.73 [36] | 5 [37] | Depression | |
ADL | Barthel Index | 10 | 0–100 | 0.89–0.97 [38] | 0.57–0.88 [39] | 1.85 [40]d | Feeding, bathing, grooming, dressing, bowels, bladder, toilet, transfer, mobility, stairs |
Instrumental Activities of Daily Living (IADL) | 8 | 0–8 | 0.92 [41] | 0.26–0.84 [41] | – | Telephone, shopping, preparing food, housekeeping, laundry, transportation, medication, finance | |
Functional Independence Measure (FIM) | 13 | 13–91 | 0.83 [42] | –0.907 [42] | 44 [43] | Self-care, toilet, transfer, locomotion, communication, social | |
QOL | Short Form-36 ( SF-36) | 36 | 0–100 | 0.63–0.81 [44] | 0.24–0.61 [45]e | 2–6 [46] | Usage fee required, physical, pain, general health, vitality, social, emotional, mental |
EQ-5D-5L, 5D-3L, VAS | 5 | 0–1 | 0.52–0.93 [47] | 0.38–0.75 [48] | 0.06–0.08 [49] | Mobility, self-care, usual activities, pain/discomfort, anxiety/depression | |
SF-12 | 12 | 0–100 | 0.77–0.89 [50] | 0.43–0.93 [50] | – | Usage fee required, physical, pain, general health, vitality, social, emotional, mental | |
Sleep | Pittsburgh Sleep Quality Index (PSQI) | 9 | 0–21 | 0.86 [51]f | 0.80 [52]g | 4.4 [53]h | Sleep quality, latency, duration, efficiency, disturbance, medication, daytime sleep dysfunction |
Pain | Brief Pain Inventory | 9, 32 | 1–10 | 0.80 [54] | – | – | General, mood, walking, work, social, sleep, enjoyment |
Family | SF-36 | 36 | 0–100 | – | – | – | QOL |
HADS | 14 | 0–14 | – | – | – | Anxiety/depression | |
IES-R | 22 | 0–4 (average) | – | – | – | PTSD |