Distinct Health-Related Quality of Life Recovery Trajectories Among ICU Survivors: A Multicentre Prospective Cohort Study Using the EQ-5D-5L.

The study was observational, so it cannot show that older age, delirium, multimorbidity, education, surgical admission or facility discharge caused different recovery trajectories. Pre-ICU HRQoL was not measured, so poor recovery may reflect impairment that existed before ICU admission rather than new post-ICU impairment. Recruitment used notices and leaflets rather than consecutive screening of all ICU admissions, so the sample may have included more engaged or less severely affected survivors. Only 609 of 891 enrolled patients completed at least one follow-up assessment. Survivors who did not respond may have been more impaired, so the study may underestimate poor recovery. Assessment mode changed from face-to-face to telephone during the pandemic, which may have affected responses or participation. The EQ-5D-5L did not directly assess cognitive function, a major component of post-intensive care syndrome. The cohort came from university hospital ICUs in one region of South Korea and had relatively low rates of mechanical ventilation and organ support, so results may not apply to more severely ill ICU populations. Trajectory groups were identified after follow-up data were collected, so prospective validation is needed before using these groups to guide care.

The authors declared no conflicts of interest. The work was funded by the National Research Foundation of Korea, with Korean government support, and the funding source had no role in the study design, analysis, data interpretation or decision to submit for publication.

Do not read the 57.4% improvement in the persistently low group as recovery. That group remained the most impaired at every time point, and the improvement likely reflects partial recovery from a very low 3-month baseline.