Joanne McPeake|Mark E. Mikkelsen|Tara Quasim|Elizabeth Hibbert|Paul J. Cannon|Martin Shaw|Jane Ankori|Theodore J. Iwashyna|Kimberley Haines
Return to Employment after Critical Illness and Its Association with Psychosocial Outcomes. A Systematic Review and Meta-Analysis
NHS Greater Glasgow and Clyde|University of Pennsylvania|Western Health|University of Glasgow|NHS Greater Glasgow and Clyde|NHS Greater Glasgow and Clyde|University of Michigan–Ann Arbor|VA Ann Arbor Healthcare System|Western Health|Australian and New Zealand Intensive Care Society|Monash University
background patients survive critical illness welldefined physical cognitive emotional familial problems however impact problems survivors ability return work financial outcomes less clearobjectives determine financial employment consequences intensive care stay performed systematic review metaanalysisdata sources searched medline embase cinahl databases 19702018 publication types except narrative reviews case reports casecontrol studies editorials included included studies assessed financial outcomes patients admitted critical care caregiversdata extraction two reviewers independently applied eligibility criteria assessed quality extracted data primary outcome reported return employment among previously employed also examined financial stress impact financial outcomes quality life psychosocial healthdata synthesis 5765 eligible abstracts 51 studies included provided data 858 caregiversfamily members 7267 patients fortytwo papers reported patient outcomes 11 papers described caregiversfamily members two papers included data patients caregiversfamily members return employment commonly reported financial outcome critical care survivors pooled estimates return employment among employed critical illness 33 95 confidence interval ci 2148 55 95 ci 4564 56 95 ci 4566 3 6 12 months respectively across studies included review positive association psychosocial health patients returned employment included improved healthrelated quality life fewer depressive symptoms regarding caregiversfamily members six studies reported changes employment reduced hours lost earningsconclusions critical illness many patients previously employed return work even one year later new job loss associated worse healthrelated quality life among survivors worse psychological function among survivors caregiversfamily members interventional research required understand best support employability critical illnessregistered prospero crd42018102360