Lioudmila V Karnatovskaia1, Phillip J Schulte2, Kemuel L Philbrick3, Margaret M Johnson4, Brenda K Anderson5, Ognjen Gajic6, Matthew M Clark3. 1. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Karnatovskaia.lioudmila@mayo.edu. 2. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States of America. 3. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States of America. 4. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL, United States of America. 5. Anesthesia Clinical Research Unit, Mayo Clinic, Rochester, MN, United States of America. 6. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States of America.
Abstract
PURPOSE: Over a third of critical illness survivors manifest significant psychocognitive impairments following discharge from the intensive care unit (ICU). It is not known which patient populations are at highest risk or if assessment at ICU discharge can guide outpatient treatment prioritization. MATERIALS AND METHODS: Prospective single center study in an academic medical center encompassing six types of ICUs assessed prevalence of psychocognitive morbidity based on ICU type and associations between initial and 3 month follow-up evaluation. Adult patients with >48 h ICU stays completed the Hospital Anxiety and Depression Scale (HADS), Impact of Events Scale-Revised (IES-R), and Montreal Cognitive Assessment-Blind (MoCA-blind). RESULTS: Of 299 patients who underwent initial assessment, 174 (58%) completed follow-up. Length of stay, MoCA-Blind, HADS-A/D and IES-R scores were similar across ICUs. Most commonly observed impairment in-hospital was cognitive (58%) followed by anxiety (45%), acute stress (39%) and depression (37%). There were significant correlations between in-hospital and follow-up psychocognitive outcomes. CONCLUSIONS: There was no significant difference in impairment by ICU type. Significant correlation between the initial assessment and follow-up scores suggests that early screening of high risk patients may identify those at greatest risk of sustained morbidity and facilitate timely intervention.
PURPOSE: Over a third of critical illness survivors manifest significant psychocognitive impairments following discharge from the intensive care unit (ICU). It is not known which patient populations are at highest risk or if assessment at ICU discharge can guide outpatient treatment prioritization. MATERIALS AND METHODS: Prospective single center study in an academic medical center encompassing six types of ICUs assessed prevalence of psychocognitive morbidity based on ICU type and associations between initial and 3 month follow-up evaluation. Adult patients with >48 h ICU stays completed the Hospital Anxiety and Depression Scale (HADS), Impact of Events Scale-Revised (IES-R), and Montreal Cognitive Assessment-Blind (MoCA-blind). RESULTS: Of 299 patients who underwent initial assessment, 174 (58%) completed follow-up. Length of stay, MoCA-Blind, HADS-A/D and IES-R scores were similar across ICUs. Most commonly observed impairment in-hospital was cognitive (58%) followed by anxiety (45%), acute stress (39%) and depression (37%). There were significant correlations between in-hospital and follow-up psychocognitive outcomes. CONCLUSIONS: There was no significant difference in impairment by ICU type. Significant correlation between the initial assessment and follow-up scores suggests that early screening of high risk patients may identify those at greatest risk of sustained morbidity and facilitate timely intervention.
Authors: Lioudmila V Karnatovskaia; Katalin Varga; Alexander S Niven; Phillip J Schulte; Midhat Mujic; Ognjen Gajic; Brent A Bauer; Matthew M Clark; Roberto P Benzo; Kemuel L Philbrick Journal: Crit Care Date: 2021-12-20 Impact factor: 19.334
Authors: Sarah Weihe; Camilla B Mortensen; Nicolai Haase; Lars P K Andersen; Thomas Mohr; Hanna Siegel; Michael Ibsen; Vibeke R L Jørgensen; David L Buck; Helle B S Pedersen; Henrik P Pedersen; Susanne Iversen; Niels Ribergaard; Bodil S Rasmussen; Robert Winding; Ulrick S Espelund; Helle Bundgaard; Christoffer G Sølling; Steffen Christensen; Ricardo S Garcia; Anne C Brøchner; Jens Michelsen; George Michagin; Lynge Kirkegaard; Anders Perner; Ole Mathiesen; Lone M Poulsen Journal: Acta Anaesthesiol Scand Date: 2022-07-13 Impact factor: 2.274