Evidence map›Paper›PMID 40773138›Full record

ArticleIntensive care medicine2025

Identifying distinct clusters of ICU survivors by integrating demographic, pre-admission quality of life, and clinical data: a large prospective cohort study.

Lucy L Porter, Lotte Hazeleger, Kirsten Bos, Koen S Simons, Johannes G van der Hoeven, Melda Yeghaian, Margaretha C E van der Woude, Susanne van Santen, Thijs C D Rettig, Marijke de Vries and 2 more

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03246334 (MONITOR-IC), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03246334 recruitingnot on this map

MONITOR-IC: a Mixed Methods Multicenter Prospective Open Cohort Study Determining and Improving Long-term Outcomes of ICU Survivors

TypeobservationalSponsorRadboud University Medical CenterRan2016 to 2050Enrolled50,000ConditionsPost-Intensive Care Syndrome (PICS)
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Observational
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lucy L PorterDepartment of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0003-3247-1467
Lotte HazelegerDepartment of Gastroenterology, Radboud University Medical Center, Nijmegen, The Netherlands.
Kirsten BosDepartment of Geriatrics, Radboud University Medical Center, Nijmegen, The Netherlands.
Koen S SimonsDepartment of Intensive Care, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands.
Johannes G van der HoevenDepartment of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Melda YeghaianDepartment of Machine Learning and Neural Computing, Donders Institute for Brain Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
Margaretha C E van der WoudeDepartment of Intensive Care, Zuyderland Medical Center, Heerlen, The Netherlands.
Susanne van SantenDepartment of Intensive Care, Maastricht University Medical Center, Maastricht, The Netherlands.
Thijs C D RettigDepartment of Anesthesiology and Intensive Care, Amphia Hospital, Breda, The Netherlands.
Marijke de VriesDepartment of Intensive Care, Maas Hospital Pantein, Boxmeer, The Netherlands.
Mark van den BoogaardDepartment of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Marieke ZegersDepartment of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands. Marieke.Zegers@radboudumc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeICU patients differ in pre-ICU health status, comorbidities, and diagnosis, forming a heterogeneous population with diverse long-term outcomes. This study explored whether clustering ICU patients by demographic, pre-admission quality of life, and clinical data, rather than by diagnosis, could identify subgroups that are more informative for patient-centered outcomes post-ICU.

methodsData from the MONITOR-IC prospective cohort study were used. Demographic, pre-admission quality of life, and clinical data from 2361 adult ICU survivors of six hospitals were used to identify clusters, using the k-prototypes algorithm. Data from five additional hospitals (n = 866) were used for external validation. Self-reported physical, mental, and cognitive functioning, and quality of life one year post-ICU were described.

resultsThe four identified clusters differed significantly in long-term physical, mental, and cognitive functioning, and quality of life. Cluster-A (n = 204), characterized by a healthy pre-ICU status, high disease severity, low Glasgow Coma Scale, and long ICU stay, had a relatively high quality of life at one year, despite experiencing a mean decline from baseline. Cluster-B (n = 877), also a healthy group before admission but less severely ill at ICU admission, reported the best outcomes. Cluster-C (n = 632) included younger, mostly female patients with moderate impairments both pre- and one-year post-ICU. Cluster-D (n = 648), characterized by a low education level and poor baseline health, reported impaired outcomes one year post-ICU, although improved compared to their pre-admission status. External validation confirmed the generalizability of these results.

conclusionThis study identified and externally validated four distinct clusters of ICU patients by integrating both clinical and non-clinical data. These clusters, which differed in long-term physical, mental, and cognitive outcomes, challenge conventional disease-based classification, and support a multidimensional approach to define subgroups of ICU patients.

trial registrationThe MONITOR-IC study was registered at ClinicalTrials.gov: NCT03246334.

Indexed as

Intensive Care UnitsQuality of LifeSurvivorsAdultAgedCluster AnalysisFemaleHealth StatusHumansMaleMiddle AgedProspective StudiesCluster analysisCritical care outcomesHealth statusQuality of life

Identifiers

PMID40773138
PMCPMC12405309

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.