Abstract
Post-intensive care syndrome (PICS) is characterized by several prolonged symptoms after critical care, including physical and cognitive dysfunctions as well as mental illness. In clinical practice, the long-term follow-up of PICS is initiated after patients have been discharged from the intensive care unit, and one of the approaches used is a PICS clinic. Although physical dysfunction and mental illness often present in combination, they have not yet been examined in detail in PICS patients. Grip strength is a useful physical examination for PICS, and is reported to be associated with mental status in the elderly. We herein investigated the relationship between grip strength and the mental status using data from our PICS clinic. We primarily aimed to analyze the correlation between grip strength and the Hospital Anxiety and Depression Scale (HADS) score. We also analyzed the association between grip strength and the EuroQol 5 Dimension (EQ5D) score as quality of life (QOL). Subjects comprised 133 patients who visited the PICS clinic at one month after hospital discharge between August 2019 and December 2020. Total HADS scores were 7 (4, 13) and 10 (6, 16) (p = 0.029) and EQ5D scores were 0.96 (0.84, 1) and 0.77 (0.62, 0.89) (p ≤ 0.0001) in the no walking disability group and walking disability group, respectively. Grip strength negatively correlated with HADS and EQ5D scores. Correlation coefficients were r = −0.25 (p = 0.011) and r = −0.47 (p < 0.0001) for HADS and EQ5D scores, respectively. Grip strength was a useful evaluation that also reflected the mental status and QOL.
Highlights
Post-intensive care syndrome (PICS) is characterized by several prolonged symptoms after critical care, which mainly include physical and cognitive dysfunctions and mental illness [1]
While the Barthel index, Medical Research Council (MRC) score, and so on, are assessed for physical function, the Hospital Anxiety and Depression Scale (HADS) score for the mental status are recommended in evaluations of PICS in addition to other examinations [14]
Our PICS clinic was started in August 2019, and all intensive care unit (ICU) patients and patients with severe conditions admitted to Emergency and Critical Care Center were referred to the PICS clinic one month after hospital discharge
Summary
Post-intensive care syndrome (PICS) is characterized by several prolonged symptoms after critical care, which mainly include physical and cognitive dysfunctions and mental illness [1]. Mental illness has a negative impact on patients with impaired quality of life (QOL) [3] and correlates with long-term survival after critical care [4]. While the Barthel index, Medical Research Council (MRC) score, and so on, are assessed for physical function, the Hospital Anxiety and Depression Scale (HADS) score for the mental status are recommended in evaluations of PICS in addition to other examinations [14]. Grip strength is one of the most useful physical examinations that may be assessed and detects slight muscle weakness as a continuous variable of muscle strength. It is evaluated in all patients in our PICS clinic
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