Comprehensive Driving Assessment to Enable Driving Resumption in Adults Recovering From Critical Illness: A Prospective Cohort Study
10 affiliations
- 1Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom.
- 2King’s College London, London, United Kingdom.
- 3QEF Mobility Services, Surrey, United Kingdom.
- 4University of Melbourne, Melbourne, VIC, Australia.
- 5Epsom and St Helier University Hospitals NHS Trust, Surrey, United Kingdom.
- 6St George’s University Hospitals NHS Foundation Trust, London, United Kingdom.
- 7Royal Berkshire NHS Foundation Trust, Reading, United Kingdom.
- 8Surrey and Sussex Healthcare NHS Trust, Surrey, United Kingdom.
- 9University of Hertfordshire, Hertfordshire, United Kingdom.
- 10East and North Herts NHS Trust, Stevenage, United Kingdom.
Abstract
OBJECTIVES:: Primary objective: To determine the driving ability of adult ICU survivors 2 months after hospital discharge. Secondary objectives: Evaluate driving resumption at 3, 6, and 12 months; factors associated with driving resumption; and acceptability of a comprehensive driving assessment.
DESIGN:: Observational cohort study.
SETTING:: Certified driving assessment center in the United Kingdom.
PATIENTS:: Adult ICU survivors who received mechanical ventilation (minimum 72 hr) and/or extracorporeal membrane oxygenation.
INTERVENTIONS:: A Driver Vehicle Licensing Agency-approved, driving ability assessment comprising physical and cognitive evaluation, and practical driving skills using a driving simulator, private track in-car assessment, and on-road in-car assessment.
MEASUREMENTS AND MAIN RESULTS:: We recruited 40 participants (median age, 53 yr [interquartile range (IQR), 46–64 yr]; 13 [32%] female) from six hospitals. Of these, 33 completed the driving assessment at a median of 12.5 weeks following hospital discharge. Twenty-six participants (79%) were assessed as capable of driving a standard vehicle; however, only 15 (45%) had resumed driving. Seven participants (7/33, 21%) were deemed unable to drive a standard vehicle due to either physical (n = 4/7, 57%), psychological (n = 2/7, 29%), or cognitive impairment (n = 1/7, 14%). Driving resumption following adaptations, retraining, or refresher lessons occurred in four participants (n = 4/7, 57%) in the 12-month study period. Self-reported driving resumption at 3, 6, and 12 months was observed in 21 (62%), 28 (82%), and 30 (91%) participants, respectively. Time to driving resumption ranged from 7 to 274 days following hospital discharge. Median (IQR) driving confidence (10-point Likert scale) increased from 7 (5–8) pre-assessment to 9 (7–10) post assessment (p < 0.05). Driving assessment acceptability was rated very good or excellent by 32 participants (97%).
CONCLUSIONS:: Using a comprehensive driving assessment 3 months following hospital discharge, approximately three quarters of this cohort were deemed able to drive a standard vehicle, yet less than half had resumed driving. Of those with a driving-related impairment, most could resume driving following intervention.
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BibTeX
@article{apps2026comprehensive,
title = {{Comprehensive Driving Assessment to Enable Driving Resumption in Adults Recovering From Critical Illness: A Prospective Cohort Study}},
author = {Chloe Apps and Kate Brooks and Gillian Radcliffe and Kieran Mahon and Patricia Helen Morris and Gavin Saunders and Michelle Giles and Leah Homden and Jessica Gregory and Paula O’Shea and Melanie Gager and Liza Keating and Amy Grimadell-Jones and Lucy Pearson and Barnaby Sanderson and Andrew Slack and Helen Vollmer and Katie Susser and Manu Shankar-Hari and Natalie Pattison and Louise Rose and Joel Meyer},
journal = {Critical Care Medicine},
year = {2026},
month = sep,
doi = {10.1097/ccm.0000000000007316},
url = {https://doi.org/10.1097/ccm.0000000000007316},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comprehensive Driving Assessment to Enable Driving Resumption in Adults Recovering From Critical Illness: A Prospective Cohort Study
AU - Chloe Apps
AU - Kate Brooks
AU - Gillian Radcliffe
AU - Kieran Mahon
AU - Patricia Helen Morris
AU - Gavin Saunders
AU - Michelle Giles
AU - Leah Homden
AU - Jessica Gregory
AU - Paula O’Shea
AU - Melanie Gager
AU - Liza Keating
AU - Amy Grimadell-Jones
AU - Lucy Pearson
AU - Barnaby Sanderson
AU - Andrew Slack
AU - Helen Vollmer
AU - Katie Susser
AU - Manu Shankar-Hari
AU - Natalie Pattison
AU - Louise Rose
AU - Joel Meyer
PY - 2026
DA - 2026/09/11
JO - Critical Care Medicine
DO - 10.1097/ccm.0000000000007316
UR - https://doi.org/10.1097/ccm.0000000000007316
AB - OBJECTIVES:: Primary objective: To determine the driving ability of adult ICU survivors 2 months after hospital discharge. Secondary objectives: Evaluate driving resumption at 3, 6, and 12 months; factors associated with driving resumption; and acceptability of a comprehensive driving assessment. DESIGN:: Observational cohort study. SETTING:: Certified driving assessment center in the United Kingdom. PATIENTS:: Adult ICU survivors who received mechanical ventilation (minimum 72 hr) and/or extracorporeal membrane oxygenation. INTERVENTIONS:: A Driver Vehicle Licensing Agency-approved, driving ability assessment comprising physical and cognitive evaluation, and practical driving skills using a driving simulator, private track in-car assessment, and on-road in-car assessment. MEASUREMENTS AND MAIN RESULTS:: We recruited 40 participants (median age, 53 yr [interquartile range (IQR), 46–64 yr]; 13 [32%] female) from six hospitals. Of these, 33 completed the driving assessment at a median of 12.5 weeks following hospital discharge. Twenty-six participants (79%) were assessed as capable of driving a standard vehicle; however, only 15 (45%) had resumed driving. Seven participants (7/33, 21%) were deemed unable to drive a standard vehicle due to either physical (n = 4/7, 57%), psychological (n = 2/7, 29%), or cognitive impairment (n = 1/7, 14%). Driving resumption following adaptations, retraining, or refresher lessons occurred in four participants (n = 4/7, 57%) in the 12-month study period. Self-reported driving resumption at 3, 6, and 12 months was observed in 21 (62%), 28 (82%), and 30 (91%) participants, respectively. Time to driving resumption ranged from 7 to 274 days following hospital discharge. Median (IQR) driving confidence (10-point Likert scale) increased from 7 (5–8) pre-assessment to 9 (7–10) post assessment (p < 0.05). Driving assessment acceptability was rated very good or excellent by 32 participants (97%). CONCLUSIONS:: Using a comprehensive driving assessment 3 months following hospital discharge, approximately three quarters of this cohort were deemed able to drive a standard vehicle, yet less than half had resumed driving. Of those with a driving-related impairment, most could resume driving following intervention.
SN - 0090-3493
SN - 1530-0293
ER -