Incidence rate and risk factors for post-intensive care syndrome subtypes among critical care survivors three months after discharge: A prospective cohort study

Abstract

ObjectivesTo investigate the incidence of post-intensive care syndrome subtypes and their risk factors among intensive care unit survivors. Research methodology/designThis prospective observational cohort study assessed post-intensive care syndrome at three months after discharge in 475 survivors (median age of 62 years, 59.4 % male) admitted for more than 24 hours to 19 intensive care units. Setting19 intensive care units at four university hospitals in Korea. Main outcome measuresThree months after discharge, the Hospital Anxiety and Depression Scale, Posttraumatic Diagnosis Scale, Montreal Cognitive Assessment, and Activities of Daily Living were used to evaluate post-intensive care syndrome. ResultsParticipants exhibited eight subtypes of post-intensive care syndrome: post-intensive care syndrome free (50.3 %), impaired in physical (3.4 %), mental (13.5 %), cognitive (12.4 %), physical and mental (7.8 %), physical and cognitive (2.3 %), mental and cognitive (4.0 %) and all three domains (6.3 %). Age, unemployment, education, comorbidities, unplanned admission, longer stay, and place of discharge were risk factors for each domain. Age ≥ 65 years (OR 9.234, p < .001), female gender (OR = 5.143, p = .002), two or more comorbidities (OR = 8.701, p = .002), and discharge to an extended care facility (OR = 36.040, p < .001) were associated with increased probability of impairment in all three domains. ConclusionThe type with impaired in both mental and physical domains was the most prevalent in cases of co-occurrence. Discharge to an extended care facility was one of the most significant risk factor for the occurrence of each domain and intensity of post-intensive care syndrome. Implications for clinical practiceNurses must promote prevention strategies by proactively evaluating intensive care unit survivors for post-intensive care syndrome risk factors. Additionally, it is necessary to raise healthcare providers' awareness of post-intensive care syndrome evaluation and management in extended care facilities.