Abstract
Background: Post-intensive care syndrome (PICS) consists of cognitive, psychiatric, and physical symptoms associated with intensive care unit (ICU) hospitalization. The occurrence of PICS in neurocritical patients is poorly characterized. We aimed to measure the prevalence of psychiatric symptoms of PICS including depression, anxiety, and post-traumatic stress disorder (PTSD) in hemorrhagic stroke (HS) and other neurocritical patients discharged to a long-term acute care facility. Methods: We reviewed patient data from January 2020 to December 2021 collected as a part of the virtual follow-up visits within 3 months after ICU discharge. Patients were excluded if the evaluation was not possible or denied. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), anxiety with the General Anxiety Disorder-7 (GAD-7) tool, and PTSD with Post-traumatic Checklist for DSM-5 (PCL-5). PHQ-9 and GAD-7 scores of 5 and more were defined as depression and anxiety. PCL-5 scores of 33 and more were defined as PTSD. Univariate analysis was performed to examine the prevalence of PICS. Pearson’s chi-square test was used to determine the difference in PICS symptoms' prevalence among hemorrhagic stroke survivors and other neurocritical patients. Results: Of the 52 neurocritical patients that had a virtual clinic follow-up, 26 (50%) patients had complete and 11 (21%) incomplete evaluations for depression, anxiety, and PTSD. The prevalence of psychiatric symptoms in this population reached 77% with depression as the most prevalent symptom (61%). The most common neurologic diagnoses were hemorrhagic stroke (33%), acute ischemic stroke (15%), seizures (15%), and status epilepticus (10%). Among hemorrhagic stroke survivors, the prevalence of depression was 56%, anxiety 19%, and PTSD 1%. Other neurocritical patients in 63% of cases had depression, 21% had anxiety, and 9% had PTSD. The prevalence of psychiatric symptoms of PICS in the two groups was not significantly different. Conclusions: Psychiatric symptoms of PICS are as prevalent in hemorrhagic stroke survivors as in other neurocritical patients. Further research is warranted to better understand PICS in this population.
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