{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T18:03:16Z","timestamp":1771610596030,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,9,26]],"date-time":"2021-09-26T00:00:00Z","timestamp":1632614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In Intensive Care Unit (ICU) survivors, critical illness has an impact on an individual\u2019s long-term health status and quality of life. Adults who have recovered from intensive care management could develop muscle weakness, neurocognitive impairment, difficulties in managing activities of daily living and to returning to work, and psychological problems such as depression and anxiety. A prospective, observational study was designed. Data were collected from January to December 2018 from a structured follow-up program, at 3 time points after ICU discharge: at seven days, a visit in the general ward, a phone interview at three months and an ambulatory visit at six months. A total of 95 patients were enrolled, 36% female, with a median age of 65 (55\u201373) years and a median ICU length of stay of 13 (8\u201320) days. At the seven days follow-up, patients who had a positive Hospital Anxiety and Depression Scale showed a significantly longer time of intubation (p = 0.048) and length of ICU stay (p = 0.023). At three months, we observed a significant relationship between a positive Hospital Anxiety and Depression Scale and a median value of EuroQol-5D (p = 0.048). At six months, we observed that patients who had a positive Post-Traumatic Symptom Scale were significantly younger than the other group. Findings from the present study suggest that a longer time of intubation and length of ICU stay are associated with a higher level of anxiety and depression immediately after ICU discharge. Follow-up programs are recommended to assess and rehabilitate cognitive function at ICU discharge.<\/jats:p>","DOI":"10.3390\/ijerph181910122","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T04:55:33Z","timestamp":1632718533000},"page":"10122","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Implementation of a Follow-Up Program for Intensive Care Unit Survivors"],"prefix":"10.3390","volume":"18","author":[{"given":"Marta","family":"Villa","sequence":"first","affiliation":[{"name":"General Intensive Care Unit, Emergency Department\u2014ASST Monza\u2014San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Villa","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, Emergency Department\u2014ASST Monza\u2014San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Vimercati","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, Emergency Department\u2014ASST Monza\u2014San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Andreossi","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, Emergency Department\u2014ASST Monza\u2014San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizia","family":"Mauri","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, Emergency Department\u2014ASST Monza\u2014San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Ferlicca","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, Emergency Department\u2014ASST Monza\u2014San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3907-3074","authenticated-orcid":false,"given":"Roberto","family":"Rona","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, Emergency Department\u2014ASST Monza\u2014San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Foti","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, Emergency Department\u2014ASST Monza\u2014San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7475-277X","authenticated-orcid":false,"given":"Alberto","family":"Lucchini","sequence":"additional","affiliation":[{"name":"General Intensive Care Unit, Emergency Department\u2014ASST Monza\u2014San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1097\/CCM.0000000000000882","article-title":"Posttraumatic stress disorder in critical illness survivors: A metaanalysis","volume":"43","author":"Parker","year":"2015","journal-title":"Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1136\/thoraxjnl-2019-213803","article-title":"Return to work after critical illness: A systematic review and meta-analysis","volume":"75","author":"Kamdar","year":"2020","journal-title":"Thorax"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1097\/CCM.0000000000001856","article-title":"ICU Admission, Discharge, and Triage Guidelines: A Framework to Enhance Clinical Operations, Development of Institutional Policies, and Further Research","volume":"44","author":"Nates","year":"2016","journal-title":"Crit. Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1056\/NEJMoa1301372","article-title":"BRAIN-ICU Study Investigators. Long-term cognitive impairment after critical illness","volume":"369","author":"Pandharipande","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1515\/jtim-2016-0016","article-title":"Post-intensive Care Syndrome: An Overview","volume":"5","author":"Rawal","year":"2017","journal-title":"J. Transl. Int. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1001\/jama.2014.2137","article-title":"Psychiatric diagnoses and psychoactive medication use among nonsurgical critically ill patients receiving mechanical ventilation","volume":"311","author":"Wunsch","year":"2014","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S2213-2600(14)70051-7","article-title":"Bringing to light the Risk Factors And Incidence of Neuropsychological dysfunction in ICU survivors (BRAIN-ICU) study investigators. Depression, post-traumatic stress disorder, and functional disability in survivors of critical illness in the BRAIN-ICU study: A longitudinal cohort study","volume":"2","author":"Jackson","year":"2014","journal-title":"Lancet Respir. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jcrc.2019.04.014","article-title":"Effects of post-ICU follow-up on subject outcomes: A systematic review and meta-analysis","volume":"52","author":"Rosa","year":"2019","journal-title":"J. Crit. Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1002\/ams2.415","article-title":"Post-intensive care syndrome: Its pathophysiology, prevention, and future directions","volume":"6","author":"Inoue","year":"2019","journal-title":"Acute Med. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.aucc.2019.10.004","article-title":"Risk Factors for Post\u2013Intensive Care Syndrome: A Systematic Review and Meta-Analysis","volume":"33","author":"Lee","year":"2020","journal-title":"Aust. Crit. Care"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Poulsen, L.M., Estrup, S., Mortensen, C.B., and Andersen-Ranberg, N.C. (2021). Delirium in Intensive Care. Curr. Anesth. Rep., 1\u20138.","DOI":"10.1007\/s40140-021-00476-z"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Stollings, J.L., Kotfis, K., Chanques, G., Pun, B.T., Pandharipande, P.P., and Ely, E.W. (2021). Delirium in critical illness: Clinical manifestations, outcomes, and management. Intensive Care Med., 1\u201315.","DOI":"10.1007\/s00134-021-06503-1"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/cc12745","article-title":"An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: A 12-month follow-up study","volume":"17","author":"Griffiths","year":"2013","journal-title":"Crit. Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1097\/CCM.0000000000001531","article-title":"Post-intensive care syndrome: Right care, right now and later","volume":"44","author":"Harvey","year":"2016","journal-title":"Crit. Care Med."},{"key":"ref_15","first-page":"CD010754","article-title":"Early intervention (mobilization or active exercise) for critically ill adults in the intensive care unit","volume":"3","author":"Doiron","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.iccn.2018.04.003","article-title":"A systematic review evaluating the role of nurses and processes for delivering early mobility interventions in the intensive care unit","volume":"47","author":"Krupp","year":"2018","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_17","first-page":"233","article-title":"Re-visiting the ICU Experiences of follow-up visits to an ICU after discharge: A qualitative study","volume":"24","author":"Andersson","year":"2008","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"b3723","DOI":"10.1136\/bmj.b3723","article-title":"The PRaCTICaL study of nurse led, intensive care follow-up programmes for improving long term outcomes from critical illness: A pragmatic randomised controlled trial","volume":"339","author":"Cuthbertson","year":"2009","journal-title":"BMJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.iccn.2012.10.005","article-title":"ICU-recovery in Scandinavia: A comparative study of intensive care follow-up in Denmark, Norway and Sweden","volume":"29","author":"Egerod","year":"2013","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1001\/jama.286.21.2703","article-title":"Delirium in Mechanically Ventilated Patients: Validity and Reliability of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)","volume":"286","author":"Ely","year":"2001","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.iccn.2014.05.002","article-title":"Delirium among critically ill adults: Evaluation of the psychometric properties of the Italian \u2018Confusion Assessment Method for the Intensive Care Unit\u2019","volume":"30","author":"Gaspardo","year":"2014","journal-title":"Intensive Crit Care Nurs."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1176\/appi.psy.47.3.223","article-title":"Incidence of posttraumatic stress disorder after prolonged surgical intensive care unit treatment","volume":"47","author":"Richter","year":"2006","journal-title":"Psychosomatics"},{"key":"ref_23","first-page":"46","article-title":"Post-traumatic stress disorder in the Ares 118 voluntary ambulance staff in the Latina area: Preliminary study to validate the PTSS-10","volume":"65","author":"Capodilupo","year":"2012","journal-title":"Prof. Inferm."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0022-3999(96)00216-4","article-title":"International experiences with the Hospital Anxiety and Depression Scale-A review of validation data and clinical results","volume":"42","author":"Herrmann","year":"1997","journal-title":"J. Psychosom. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/1477-7525-1-29","article-title":"The Hospital Anxiety and Depression Scale","volume":"1","author":"Snaith","year":"2003","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.jcrc.2015.04.006","article-title":"Psychometric evaluation of the Hospital Anxiety and Depression Scale 3 months after acute lung injury","volume":"30","author":"Jutte","year":"2015","journal-title":"J. Crit. Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s005200050241","article-title":"Detecting psychological distress in cancer patients: Validity of the Italian version of the Hospital Anxiety and Depression Scale","volume":"7","author":"Costantini","year":"1999","journal-title":"Support. Care Cancer"},{"key":"ref_28","first-page":"61","article-title":"Functional evaluation: The Barthel index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md. State Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3109\/09638288809164103","article-title":"The Barthel ADL Index: A reliability study","volume":"10","author":"Collin","year":"1988","journal-title":"Int. Disabil. Stud."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"221","DOI":"10.11138\/FNeur\/2017.32.4.221","article-title":"The culturally adapted Italian version of the Barthel Index (IcaBI): Assessment of structural validity, inter-rater reliability and responsiveness to clinically relevant improvements in patients admitted to inpatient rehabilitation centers","volume":"22","author":"Castiglia","year":"2017","journal-title":"Funct. Neurol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3109\/07853890109002087","article-title":"EQ-5D: A measure of health status from the EuroQol Group","volume":"33","author":"Rabin","year":"2001","journal-title":"Ann. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/1477-7525-4-47","article-title":"Assessing the construct validity of the Italian version of the EQ-5D: Preliminary results from a cross-sectional study in North Italy","volume":"4","author":"Savoia","year":"2006","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1177\/0885066619885838","article-title":"Six-Minute Walk Distance After Critical Illness: A Systematic Review and Meta-Analysis","volume":"36","author":"Parry","year":"2021","journal-title":"J. Intensive Care Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1183\/09031936.00150314","article-title":"An official European Respiratory Society\/American Thoracic Society technical standard: Field walking tests in chronic respiratory disease","volume":"44","author":"Holland","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1097\/CCM.0000000000004586","article-title":"Society of Critical Care Medicine\u2019s International Consensus Conference on Prediction and Identification of Long-Term Impairments After Critical Illness","volume":"48","author":"Mikkelsen","year":"2020","journal-title":"Crit. Care Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1513\/AnnalsATS.201606-455OC","article-title":"Recovery from Dysphagia Symptoms after Oral Endotracheal Intubation in Acute Respiratory Distress Syndrome Survivors. A 5-Year Longitudinal Study","volume":"14","author":"Brodsky","year":"2017","journal-title":"Ann. Am. Thorac.Soc."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"McIntyre, M., Chimunda, T., Koppa, M., Dalton, N., Reinders, H., and Doeltgen, S. (2020). Risk Factors for Postextubation Dysphagia: A Systematic Review and Meta-analysis. Laryngoscope.","DOI":"10.1002\/lary.29311"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"McInytre, M., Doeltgen, S., Shao, C., and Chimunda, T. (2021). The incidence and clinical outcomes of post-extubation dysphagia in a regional critical care setting. Aust. Crit. Care.","DOI":"10.1016\/j.aucc.2021.03.008"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1177\/0885066620954787","article-title":"Reducing the Risk and Impact of Brachial Plexus Injury Sustained from Prone Positioning-A Clinical Commentary","volume":"35","author":"Simpson","year":"2020","journal-title":"J. Intensive Care Med."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Miller, C., O\u2019Sullivan, J., Jeffrey, J., and Power, D. (2021). Brachial Plexus Neuropathies During the COVID-19 Pandemic: A Retrospective Case Series of 15 Patients in Critical Care. Phys. Ther., 101.","DOI":"10.1093\/ptj\/pzaa191"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.apmr.2020.10.131","article-title":"Nerve Compression Injuries After Prolonged Prone Position Ventilation in Patients With SARS-CoV-2: A Case Series","volume":"102","author":"Brugliera","year":"2021","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1097\/CCM.0000000000004818","article-title":"Safety and Outcomes of Prolonged Usual Care Prone Position Mechanical Ventilation to Treat Acute Coronavirus Disease 2019 Hypoxemic Respiratory Failure","volume":"49","author":"Douglas","year":"2021","journal-title":"Crit. Care Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1056\/NEJMoa1214103","article-title":"Prone positioning in severe acute respiratory distress syndrome","volume":"368","author":"Reignier","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1007\/s00134-020-06306-w","article-title":"Prone position in ARDS patients: Why, when, how and for whom","volume":"46","author":"Albert","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"E381","DOI":"10.1503\/cmaj.140081","article-title":"Effect of prone positioning during mechanical ventilation on mortality among patients with acute respiratory distress syndrome: A systematic review and meta-analysis","volume":"186","author":"Sud","year":"2014","journal-title":"CMAJ"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"27","DOI":"10.4037\/ccn2020222","article-title":"Nursing Management of Prone Positioning in Patients With COVID-19","volume":"41","author":"Binda","year":"2021","journal-title":"Crit. Care Nurs."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.iccn.2018.04.002","article-title":"Application of prone position in hypoxaemic patients supported by veno-venous ECMO","volume":"48","author":"Lucchini","year":"2018","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/DCC.0000000000000393","article-title":"Prone Position in Acute Respiratory Distress Syndrome Patients: A Retrospective Analysis of Complications","volume":"39","author":"Lucchini","year":"2020","journal-title":"Dimens. Crit. Care Nurs."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3386","DOI":"10.1111\/jocn.14951","article-title":"Nurse-led post-discharge telephone follow-up calls: A mixed study systematic review","volume":"28","author":"Woods","year":"2019","journal-title":"J. Clin. Nurs."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/nicc.12459","article-title":"Elements of intensive care bereavement follow-up services: A European survey","volume":"24","author":"Egerod","year":"2019","journal-title":"Nurs. Crit. Care"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/19\/10122\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:05:27Z","timestamp":1760166327000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/19\/10122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,26]]},"references-count":50,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["ijerph181910122"],"URL":"https:\/\/doi.org\/10.3390\/ijerph181910122","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,26]]}}}