Analysis of the characteristics and influencing factors of early comprehensive symptoms in elderly patients after ICU

Abstract

Research methods: In order to solve the early syndrome of elderly patients after ICU and provide reference for the treatment of elderly patients with post ICU syndrome, this paper studied the characteristics of early symptoms of elderly patients and analyzed the influencing factors. This article describes the frequency of newly acquired cognitive impairment, activities of daily living (ADL) and depression among the elderly survivors of critical illness. Finally, the predictive factors of asymptomatic elderly patients with post intensive care syndrome (PICS) (i.e., no PICS problems) were evaluated and analyzed. Subjects: This article selects many elderly ICU patients from the internal medicine and surgery departments of ICU in major hospitals in a city. They all have respiratory failure, shock and other characteristics, ignoring patients with cognitive impairment or ADL disability. To study the characteristics of the above elderly patients at 3 and 12 months after discharge. The research samples were divided into eight groups, and the mental health problems, cognitive problems and physical disability problems of these eight groups of elderly patients were studied in combination. By using the control variable method and multivariable logistic regression analysis, the relationship between age, education level, weakness report entering ICU, time of mechanical ventilation, delirium and severe sepsis and the probability of no PICS was obtained. Study data: The sample is 406 patients, of whom the average age is 61 years old. The study found that 64% of the elderly patients had one or more PICS problems at 3 months, and the total number of patients with more than 2 PICS accounted for 25% of the total proportion, while only 6% of patients with more than 3 PICS; When the time was 12 months, the proportion of patients with one or more PICS problems decreased to 56%, and the total number of patients with more than 2 PICS accounted for 21% of the total proportion, while only 4% of patients with more than 3 PICS. This means that when the recovery time of patients after ICU is longer and longer, the proportion of patients will gradually decline. In addition, the longer the elderly patients were educated, the greater the possibility of no PICS. The data showed that at 3 and 12 months, P<0.001. The low probability of no PICS was associated with more severe frailty. The data showed that P=0.005 at 3 months and P=0.048 at 12 months. Conclusion: In this multicenter cohort study, most survivors have one or more PICS problems, but only 1/4 of the patients have merger problems. Future studies need to better understand the heterogeneous subtypes of PICS and identify modifiable risk factors. In the elderly patient group, the incidence rate of PICS has nothing to do with whether they have received education, but it is related to the doctor's weak diagnosis report of elderly patients when they enter the ICU. The lower the score of the report, the higher the incidence rate of PICS.