Navigating the Urgency: A Narrative Review on the Critical Demand for Robust Outcome Measures in Post-Intensive Care Syndrome (PICS)

Abstract

Abstract Background Post intensive care syndrome (PICS) is a new emerging condition affecting more than 80% of the population discharged from Intensive care unit (ICU). It affects the individual with a myriad of symptoms degrading the individual’s quality of life (QoL). Most critical method to prevent this is early diagnosis through a reliable measure taking into account the multidimensional nature of PICS. Thus, this study aims to find out is there a need of a comprehensive assessment scale for PICS covering all the domains. Methods Data was searched on databases incorporating PubMed, Cochrane Library, Google Scholar and EBSCO, Psyc INFO, Web of Science, Scopus, Science Direct, Medline, CINAHL. 18,756 articles were retrieved. It was narrowed down to 20 articles which were finally reviewed. The review summarizing all the reasons why a comprehensive outcome measure is needed for PICS including all the aspects of the syndrome. Furthermore, the review delineates the potential advantages that a novel assessment tool could provide, enriching our comprehension and handling of the intricate ramifications of PICS. Results The review highlights several key findings that underscore the necessity of a thorough outcome measure for assessing PICS: (i) the multifaceted nature of symptoms; (ii) challenges related to underdiagnosis and misdiagnosis; (iii) inconsistencies in assessment measures; (iv) insufficient attention to social aspects; (v) confounding factors related to comorbidities; (vi) the diverse array of assessment measures presently employed. All this is currently contributing to a confusing assessment of PICS leading to increased population affected with multitude of symptoms experienced after ICU discharge. Conclusion The existing assessment instruments for PICS exhibit wide variability in complexity, difficult comparison and evidence integration, thereby complicating therapeutic decisions. The lack of a universally accepted measurement standard increases the challenge of diagnosing and preventing PICS. Additionally, some tools may inaccurately represent PICS characteristics, leading to inconsistent reporting. Thus, there is an urgent demand for a comprehensive, multidimensional tool to provide a valid diagnosis.

Keywords

• Post intensive care syndrome
• Intensive care unit
• Instruments
• Critical care survivors