Prevalence and incidence of post-intensive care syndrome among intensive care unit survivors: a systematic review and meta-analysis

Post-intensive care syndrome (PICS) is a post-discharge complication from the intensive care unit (ICU) that manifests as a range of physical, cognitive, and psychological impairments for patients. Given the growing number of ICU survivors and the vital role of this syndrome in identifying individuals at risk of deterioration after ICU discharge, we conducted a systematic review and meta-analysis to assess the prevalence and incidence of PICS. Between January 1, 2010, and October 5, 2024, a thorough search was conducted across the Web of Science, PubMed, Scopus, Embase, Cochrane Library, and CINAHL databases. Cross-sectional and cohort studies were included. The prevalence and incidence of PICS, as determined by any assessment method, were the primary study outcomes. PICS was defined according to the criteria used in each primary study. A meta-analysis was performed using a random-effects model. Meta-regression analysis was employed to investigate the impact of distinct follow-up durations on the reported prevalence and incidence. The JBI critical appraisal tool for prevalence studies was used to assess the risk of bias in the included studies. This systematic review and meta-analysis synthesised data from 34 studies involving 6230 participants. The pooled prevalence and incidence of PICS were 60.3% (95% CI: 48.5–72.1) and 52.4% (95% CI: 47.6–57.2), respectively. The I2 statistic for heterogeneity in the included prevalence and incidence studies was 98.67% and 81.23%, respectively. Subgroup analyses by country, cutoff definition, and underlying participant disease revealed a substantial reduction in heterogeneity. Only the use of a cutoff substantially reduced heterogeneity in reported incidence across studies. This systematic review and meta-analysis demonstrate a notable prevalence and incidence of PICS among ICU survivors. These findings highlight the need for early detection of at-risk individuals and the development of evidence-based approaches to monitor and address impairments related to PICS.