Post-intensive cardiac care outpatient long-term outreach clinic (PICCOLO clinic): Defining health care needs and outcomes among coronary care unit survivors
Objective: Patients who survive critical illness endure complex physical and mental health conditions, referred to as post-intensive care syndrome (PICS). The University of Michigan's post-intensive cardiac care outpatient long-term outreach (PICCOLO) clinic is designed for patients recently ad...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-02-01
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| Series: | American Heart Journal Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602224000065 |
| _version_ | 1797326247939801088 |
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| author | Christopher K. Mason Sara K. Adie Michael J. Shea Matthew C. Konerman Michael P. Thomas Jakob I. McSparron Theodore J. Iwashyna Hallie C. Prescott Andrea D. Thompson |
| author_facet | Christopher K. Mason Sara K. Adie Michael J. Shea Matthew C. Konerman Michael P. Thomas Jakob I. McSparron Theodore J. Iwashyna Hallie C. Prescott Andrea D. Thompson |
| author_sort | Christopher K. Mason |
| collection | DOAJ |
| description | Objective: Patients who survive critical illness endure complex physical and mental health conditions, referred to as post-intensive care syndrome (PICS). The University of Michigan's post-intensive cardiac care outpatient long-term outreach (PICCOLO) clinic is designed for patients recently admitted to the coronary care unit (CCU). The long-term goal of this clinic is to understand post-CCU patients' needs and design targeted interventions to reduce their morbidity and mortality post-discharge. As a first step toward this goal, we aimed to define the post-discharge needs of CCU survivors. Design, setting, particpants: We retrospectively reviewed case-mix data (including rates of depression, PTSD, disability, and cognitive abnormalities) and health outcomes for patients referred to the PICCOLO clinic from July 1, 2018, through June 30, 2021 at Michigan Medicine. Results: Of the 134 referred patients meeting inclusion criteria, 74 (55 %) patients were seen in the PICCOLO clinic within 30 days of discharge. Patients seen in the clinic frequently screened positive for depression (PHQ-2 score ≥3, 21.4 %) and cognitive impairment (MOCA <26, 38.8 %). Further, patients also reported high rates of physical difficulty (mean WHODAS 2.0 score 28.4 %, consistent with moderate physical difficulty). Consistent with medical intensive care unit (ICU) patients, CCU survivors experience PICS. Conclusion: This work highlights the feasibility of an outpatient care model and the need to leverage information gathered from this care model to develop treatment strategies and pathways to address symptoms of PICS in CCU survivors, including depression, cognitive impairment, and physical disability. |
| first_indexed | 2024-03-08T06:20:40Z |
| format | Article |
| id | doaj.art-b4485879e19e4070973a180acf608ace |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-03-08T06:20:40Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-b4485879e19e4070973a180acf608ace2024-02-04T04:46:48ZengElsevierAmerican Heart Journal Plus2666-60222024-02-0138100363Post-intensive cardiac care outpatient long-term outreach clinic (PICCOLO clinic): Defining health care needs and outcomes among coronary care unit survivorsChristopher K. Mason0Sara K. Adie1Michael J. Shea2Matthew C. Konerman3Michael P. Thomas4Jakob I. McSparron5Theodore J. Iwashyna6Hallie C. Prescott7Andrea D. Thompson8Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States of AmericaDepartment of Pharmacy Service, University of Michigan, Ann Arbor, MI, United States of AmericaDepartment of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States of AmericaDepartment of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States of AmericaDepartment of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States of AmericaDepartment of Internal Medicine, Division of Pulmonary and Critical Care, Ann Arbor, MI, United States of AmericaDepartment of Internal Medicine, Division of Pulmonary and Critical Care, Johns Hopkins Medicine, Baltimore, MD, United States of AmericaDepartment of Internal Medicine, Division of Pulmonary and Critical Care, Ann Arbor, MI, United States of America; VA Center for Clinical Management Research, Ann Arbor, MI, United States of AmericaDepartment of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, MI, United States of America; Corresponding author at: University of Michigan, Department of Internal Medicine, Division of Cardiovascular Medicine, 1150 W Medical Center Dr. 7220B Medical Science Research Building II, Ann Arbor, MI 48109, United States of America.Objective: Patients who survive critical illness endure complex physical and mental health conditions, referred to as post-intensive care syndrome (PICS). The University of Michigan's post-intensive cardiac care outpatient long-term outreach (PICCOLO) clinic is designed for patients recently admitted to the coronary care unit (CCU). The long-term goal of this clinic is to understand post-CCU patients' needs and design targeted interventions to reduce their morbidity and mortality post-discharge. As a first step toward this goal, we aimed to define the post-discharge needs of CCU survivors. Design, setting, particpants: We retrospectively reviewed case-mix data (including rates of depression, PTSD, disability, and cognitive abnormalities) and health outcomes for patients referred to the PICCOLO clinic from July 1, 2018, through June 30, 2021 at Michigan Medicine. Results: Of the 134 referred patients meeting inclusion criteria, 74 (55 %) patients were seen in the PICCOLO clinic within 30 days of discharge. Patients seen in the clinic frequently screened positive for depression (PHQ-2 score ≥3, 21.4 %) and cognitive impairment (MOCA <26, 38.8 %). Further, patients also reported high rates of physical difficulty (mean WHODAS 2.0 score 28.4 %, consistent with moderate physical difficulty). Consistent with medical intensive care unit (ICU) patients, CCU survivors experience PICS. Conclusion: This work highlights the feasibility of an outpatient care model and the need to leverage information gathered from this care model to develop treatment strategies and pathways to address symptoms of PICS in CCU survivors, including depression, cognitive impairment, and physical disability.http://www.sciencedirect.com/science/article/pii/S2666602224000065Critical careTransitions of carePost intensive care syndromeRecovery |
| spellingShingle | Christopher K. Mason Sara K. Adie Michael J. Shea Matthew C. Konerman Michael P. Thomas Jakob I. McSparron Theodore J. Iwashyna Hallie C. Prescott Andrea D. Thompson Post-intensive cardiac care outpatient long-term outreach clinic (PICCOLO clinic): Defining health care needs and outcomes among coronary care unit survivors American Heart Journal Plus Critical care Transitions of care Post intensive care syndrome Recovery |
| title | Post-intensive cardiac care outpatient long-term outreach clinic (PICCOLO clinic): Defining health care needs and outcomes among coronary care unit survivors |
| title_full | Post-intensive cardiac care outpatient long-term outreach clinic (PICCOLO clinic): Defining health care needs and outcomes among coronary care unit survivors |
| title_fullStr | Post-intensive cardiac care outpatient long-term outreach clinic (PICCOLO clinic): Defining health care needs and outcomes among coronary care unit survivors |
| title_full_unstemmed | Post-intensive cardiac care outpatient long-term outreach clinic (PICCOLO clinic): Defining health care needs and outcomes among coronary care unit survivors |
| title_short | Post-intensive cardiac care outpatient long-term outreach clinic (PICCOLO clinic): Defining health care needs and outcomes among coronary care unit survivors |
| title_sort | post intensive cardiac care outpatient long term outreach clinic piccolo clinic defining health care needs and outcomes among coronary care unit survivors |
| topic | Critical care Transitions of care Post intensive care syndrome Recovery |
| url | http://www.sciencedirect.com/science/article/pii/S2666602224000065 |
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