The effects of critical care on long-term outcomes

Published in


McPeake, J., Quasim, T., Henderson, P., et al. (2021) Multimorbidity and Its Relationship With Long-Term Outcomes After Critical Care Discharge: A Prospective Cohort Study. Chest, 160(5), pp. 1681–1692.

  • 01 June 2023


Why it matters

It’s known that people who survive critical illness often have poor long-term outcomes which can result in them using healthcare more frequently after they have been discharged from critical care. But less is understood about the ways in which way multi-morbidities (having more than two illnesses at one time) can also affect long term outcomes.

The number of people who are admitted to critical care internationally continues to steadily increase and there’s evidence that being discharged is often just the start of a challenging recovery trajectory for both patients and their caregivers. This process can involve physical, social, cognitive, and emotional problems in the years after discharge.

This study looked at whether critical care patients had different mortality rates or readmission risks compared with other hospitalised patients who do not need care in a critical care environment and examined baseline patient demographics to see how they impacted mortality and use of healthcare in the year after discharge from critical care.


The following three questions were asked using data from the UK Biobank, a large prospective health resource for research which aims to improve the prevention, diagnosis, and treatment of a range of illnesses:

The study then assessed the differences in outcomes between patients with a critical care encounter and patients who had been admitted to hospital but not to critical care. Long-term mortality was examined using nationally linked data, as was hospital resource use in the year after patients were discharged from hospital. The cause of death was also observed.

Project findings

The study revealed an increased resource use for critical care survivors in the year after discharge. It was also found that in line with previous research, readmissions in the year after hospital discharge were significantly higher in the critical care cohort.

Using data from the UK Biobank, it was demonstrated that the long-term mortality of patients who had been discharged from critical care was no different from that of a matched control group after adjustment. However, the research found that mortality was more than double in those participants with two or more documented comorbidities compared with those without comorbidities. In line with previous research, readmissions in the year after people had been discharged from hospital were significantly higher in the critical care cohort.

This study also reflects the previous association between lower socioeconomic status and higher short and long-term mortality after critical illness which has been described in previous research and underlines important concepts: that the social circumstances in which people live are important to recovery from critical care and should be prioritised both during and after the critical care encounter through appropriate rehabilitation and mental health services.

Multimorbidity, lifestyle factors, and socioeconomic status all appear to influence long-term outcomes and should be the focus of future research.

Read the paper in full

Listen to Jo’s podcast from November 2021

Licensed under Creative Commons

These symbols show that the contents of this page are published under a Creative Commons licence called CC-BY-NC-ND 4.0.

It means that you’re free to reuse this work. In fact, we encourage it. We want our research to reach people who can help improve quality and safety in healthcare. But we do have a few rules:

  • Make sure you acknowledge The Healthcare Improvement Studies Institute (THIS Institute) as the creator and link back to this webpage.
  • You can’t sell this work for a fee, or use it for any activity that generates revenue without our permission.
  • Please don’t distribute a modified version to others without our permission.

You can read the fine print about the licence on the Creative Commons website. It’s meant to help us keep the integrity of our work and stay true to our values.

But ultimately we want our work to have impact. So if you’ve got a use in mind but you’re not sure it’s allowed, just ask us at