LAUSR

We wish to discuss the results of “Organ support therapy in the intensive care unit and return to work: a nationwide, register-based cohort study” [1]. The authors used the Danish registry data for 10 years, demonstrating that mechanical ventilation and longer ICU length of stay (LOS) were associated with reduced chance of returning to work. Mechanical ventilation is a risk factor of post intensive care syndrome (PICS), characterized by cognitive, psychiatric and/or physical impairment. Since 2010, an evidence-based organizational approach called the ABCDE bundle has been applied to patients with mechanical ventilation to help improve clinical outcomes [2]. Was mechanical ventilation associated with a decreased chance of return to work in the subgroup analysis of 2725 ICU survivors (2011– 2014)? Did difference in time period affect the hazard ratio for return to work? Additionally, rehabilitation for patients with critical illness is one typical strategic approach for supporting recovery following critical illness and addressing symptoms of PICS [3]. Is there a procedure code for rehabilitation in the Danish National Patient Registry? If some of the participants in this study were not provided rehabilitation services in the ICU as standard care, did being provided rehabilitation services change the relationship between mechanical ventilation and chances of return to work? The information regarding rehabilitation services might help the readers better understand the results. Elucidating the aforementioned factors might help us to better interpret the results of Riddersholm et al. and to establish better care and rehabilitation services to better support return to work.