Is new care strategy required for survivors of critical illnesses with multimorbidity?
Recently published study reviewed the impact of multimorbidity on the recovery trajectories and outcomes of critical illness survivors, aiming to identify factors that predispose such survivors to worse outcomes and explore potential strategies to enhance their long-term recovery.
Influence of Multimorbidity on Critical Illness Outcomes
The study notes that previous research efforts have largely focused on rehabilitation interventions to address physical, psychological, and cognitive functional sequelae after critical illness. However, recent evidence suggests that a person’s existing health status, particularly multimorbidity and frailty, strongly influences long-term outcomes. The review examines the complex relationship between multimorbidity and patient outcomes after critical illness, highlighting the multitude of factors, including the number, severity, and modifiability of medical conditions, treatment burden, functional status, healthcare delivery, and social support, that mediate these relationships.
Factors Mediating the Relationship
Critical illness survivors with multimorbidity, defined as the coexistence of at least two chronic conditions, experience significantly worse recovery trajectories and outcomes compared to previously healthy patients. The review proposes that the impact of the acute illness on survivors with multimorbidity may be overwhelmed by pre-illness factors, leading to worse outcomes. Several factors play a role in mediating the relationship between multimorbidity and outcomes, including biological and pathophysiological mechanisms, specific conditions and multimorbidity clusters, functional impairment and frailty, social context, treatment burden, and healthcare context. The review also explores the potential mechanisms by which critical illness may drive biological aging and exacerbate existing conditions.
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