R P Kosilek1, K Schmidt2, S E Baumeister3, J Gensichen4. 1. Institute of General Practice and Family Medicine, LMU Klinikum, Munich, Germany. Electronic address: robert_philipp.kosilek@med.uni-muenchen.de. 2. Institute of General Practice and Family Medicine, Charité University Medicine Berlin, Berlin, Germany; Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany. 3. Chair of Epidemiology, LMU München, UNIKA-T Augsburg, Augsburg, Germany; Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany. 4. Institute of General Practice and Family Medicine, LMU Klinikum, Munich, Germany.
Abstract
BACKGROUND: Post-intensive care syndrome (PICS) is a combination of cognitive, psychiatric and physical impairments in survivors of critical illness and intensive care. There is little data on long-term co-occurrence of associated impairments. METHODS: Analysis of data from 289 sepsis survivors from a German multicenter RCT. Impairments associated with PICS (depression, PTSD, cognitive impairment, chronic pain, neuropathic symptoms, dysphagia) during 24 months follow-up are used to explore the frequency and risk factors of PICS components in three classification models. RESULTS: The majority of participants showed impairments in 2-3 of 6 domains during follow-up. The overall frequency of PICS according to the classification models ranged from 32.9% to 98.6%. In regression analyses, there were no significant effects in selected ICU-related exposures or covariates for PICS classification models. Regarding individual components, only higher age and longer duration of ICU treatment and mechanical ventilation showed significant positive associations with the occurrence of cognitive impairment during follow-up, as did male gender and higher age for dysphagia. CONCLUSIONS: Almost all study participants showed impairments associated with PICS in at least one domain. The proposed classification models for PICS appear to be too broad to identify specific risk factors beyond its individual components.
RCT Entities:
BACKGROUND: Post-intensive care syndrome (PICS) is a combination of cognitive, psychiatric and physical impairments in survivors of critical illness and intensive care. There is little data on long-term co-occurrence of associated impairments. METHODS: Analysis of data from 289 sepsis survivors from a German multicenter RCT. Impairments associated with PICS (depression, PTSD, cognitive impairment, chronic pain, neuropathic symptoms, dysphagia) during 24 months follow-up are used to explore the frequency and risk factors of PICS components in three classification models. RESULTS: The majority of participants showed impairments in 2-3 of 6 domains during follow-up. The overall frequency of PICS according to the classification models ranged from 32.9% to 98.6%. In regression analyses, there were no significant effects in selected ICU-related exposures or covariates for PICS classification models. Regarding individual components, only higher age and longer duration of ICU treatment and mechanical ventilation showed significant positive associations with the occurrence of cognitive impairment during follow-up, as did male gender and higher age for dysphagia. CONCLUSIONS: Almost all study participants showed impairments associated with PICS in at least one domain. The proposed classification models for PICS appear to be too broad to identify specific risk factors beyond its individual components.
Keywords:
Critical care [MESH: N02.421.585.190]; Critical illness [MESH: C23.550.291.625]; Health services needs and demand [MESH: N05.300.450]; Post intensive care syndrome
Authors: Juan J López-Gómez; Paula Lastra-González; Emilia Gómez-Hoyos; Ana Ortolá-Buigues; R Jiménez-Sahagún; Laura Cuadrado-Clemente; Katia Benito-Sendín-Plaar; Sara Cuenca-Becerril; Esther Portugal-Rodríguez; Daniel A De Luis Román Journal: Endocrinol Diabetes Nutr Date: 2022-01-07