Abstract
ContextPost-ICU syndrome (PICS)is a common impairment that develops after critical illness and persists after discharge. It is considered when a new or worsening impairment in physical, cognitive, or mental status develops among survivors from critical illness.AimTo assess the prevalence of PICS and to define the profile of patients at risk of each domain.Patients and methodsA total of 420 critically ill patients were assessed at the time of ICU discharge for presence of one or more domains of PICS: cognitive dysfunction, psychiatric impairment, and physical disability.ResultsA total of 220 (52.4%) patients without preexisting impairment developed one or more PICS forms. Half of the participants developed cognitive impairment, 14.29% developed depression, 26.19 developed anxiety, and 35.71% experienced both muscle weakness and impaired balance. PICS presented in three different patterns: pattern A, with one domain, in which 2.38% presented with either cognitive or psychiatric affection; pattern B, with two (19.05%) domains, where 80 patients had cognitive dysfunction, combined with physical affection in 30 patients and psychiatric impairment in 50 patients; and pattern C, with all PICS domains (28.57%). Multivariate analysis was used to detect independent predictors associated with each domain of PICS.ConclusionSurvivors from critical illness should be screened for different domains of PICS. Cognitive impairment was evident in those with prolonged duration of mechanical ventilation (MV), delirium, stroke, and hypotension. Psychiatric impairment was evident in females with prolonged sedation and duration of MV, delirium, and hypoglycemia. Physical impairments were evident in those with sepsis, undernutrition, and prolonged duration of MV.
Highlights
Post-ICU syndrome (PICS) is a common impairment that develops after critical illness and persists after discharge from ICU
PICS presented in three different patterns: pattern A, with one domain, in which 2.38% presented with either cognitive or psychiatric affection; pattern B, with two (19.05%) domains, where 80 patients had cognitive dysfunction, combined with physical affection in 30 patients and psychiatric impairment in 50 patients; and pattern C, with all PICS domains (28.57%)
PICS presented in three different patterns: pattern A, which had one domain, in which 2.3% presented with either cognitive or psychiatric affection; pattern B, with two domains (19.05%), where 80 patients had all cognitive dysfunction combined with physical affection in 30 patients and psychiatric impairment in 50 patients; and pattern C, which developed all PICS domains (28.57%)
Summary
Post-ICU syndrome (PICS) is a common impairment that develops after critical illness and persists after discharge from ICU. It is considered when a new or worsening impairment in physical, cognitive, or mental health status develops among survivors from critical illness [1]. Risk factors include prior cognitive impairment, prolonged mechanical ventilation (MV), glucose dysregulation, duration of delirium, stroke, alcoholism, hypoxia, hypotension, severe sepsis, and acute respiratory distress syndrome (ARDS) [3]. This study aimed at assessment of the prevalence of PICS among survivors from respiratory critical illness and to define the profile of patients at risk of each domain Risks include multisystem organ failure, sepsis, prolonged sedation use, and MV (>7 days) [7,8].
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