Abstract

IntroductionPost-traumatic stress disorder (PTSD) has been identified in a significant portion of intensive care unit (ICU) survivors. We sought to identify factors associated with PTSD symptoms in patients following critical illness requiring mechanical ventilation.MethodsForty-three patients who were mechanically ventilated in the medical and coronary ICUs of a university-based medical center were prospectively followed during their ICU admission for delirium with the Confusion Assessment Method for the ICU. Additionally, demographic data were obtained and severity of illness was measured with the APACHE II (Acute Physiology and Chronic Health Evaluation II) score. Six months after discharge, patients were screened for PTSD symptoms by means of the Post-Traumatic Stress Syndrome 10-Questions Inventory (PTSS-10). Multiple linear regression was used to assess the association of potential risk factors with PTSS-10 scores.ResultsAt follow-up, six (14%) patients had high levels of PTSD symptoms. On multivariable analysis, women had higher PTSS-10 scores than men by a margin of 7.36 points (95% confidence interval [CI] 1.62 to 13.11; p = 0.02). Also, high levels of PTSD symptoms were less likely to occur in older patients, with symptoms declining after age 50 (p = 0.04). Finally, although causation cannot be assumed, the total dose of lorazepam received during the ICU stay was associated with PTSD symptoms; for every 10-mg increase in cumulative lorazepam dose, PTSS-10 score increased by 0.39 (95% CI 0.17 to 0.61; p = 0.04). No significant relationship was noted between severity of illness and PTSD symptoms or duration of delirium and PTSD symptoms.ConclusionHigh levels of PTSD symptoms occurred in 14% of patients six months following critical illness necessitating mechanical ventilation, and these symptoms were most likely to occur in female patients and those receiving high doses of lorazepam. High levels of PTSD symptoms were less likely to occur in older patients.

Highlights

  • Post-traumatic stress disorder (PTSD) has been identified in a significant portion of intensive care unit (ICU) survivors

  • Causation cannot be assumed, the total dose of lorazepam received during the ICU stay was associated with PTSD symptoms; for every 10-mg increase in cumulative lorazepam dose, Post-Traumatic Stress Syndrome 10-Questions Inventory (PTSS-10) score increased by 0.39

  • High levels of PTSD symptoms occurred in 14% of patients six months following critical illness necessitating mechanical ventilation, and these symptoms were most likely to occur in female patients and those receiving high doses of lorazepam

Read more

Summary

Introduction

Post-traumatic stress disorder (PTSD) has been identified in a significant portion of intensive care unit (ICU) survivors. The acute illnesses that threaten each patient's life create formidable stress These experiences may result in long-term morbidity in survivors of critical illness, including depression, anxiety, and other psychological disorders [3]. One such psychological outcome, post-traumatic stress disorder (PTSD), has been identified in a significant portion of ICU survivors [4]. Identification of patients who are at high risk for the development of PTSD after critical illness may facilitate the implementation of strategies focused on preventing this untoward outcome. No previous studies of PTSD after critical illness have incorporated formal evaluations of delirium

Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call