Associations Between Physical, Cognitive, and Mental Health Domains of Post-Intensive Care Syndrome and Quality of Life: A Longitudinal Multicenter Cohort Study.

IF 7.7 1区医学 Q1 CRITICAL CARE MEDICINE Critical Care Medicine Pub Date : 2024-10-24 DOI:10.1097/CCM.0000000000006461

Bram Tilburgs, Koen S Simons, Stijn Corsten, Brigitte Westerhof, Thijs C D Rettig, Esther Ewalds, Marieke Zegers, Mark van den Boogaard

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Abstract

Objectives: To explore associations between the physical, cognitive, and mental post-intensive care syndrome (PICS) health domains with changes in health-related quality of life (HRQoL) following ICU admission.

Design: A longitudinal prospective multicenter cohort study.

Setting/patients: Patients (n = 4092) from seven Dutch ICUs.

Interventions: None.

Measurements and main results: At ICU admission, 3 and 12 months post-ICU, patients completed validated questionnaires regarding physical health problems, cognitive health problems, mental health problems, and HRQoL. Composite scores were created for the physical health domain (physical problems and fatigue) and mental health domain (anxiety, depression, and post-traumatic stress disorder). Adjusted multivariable linear regression analyses were performed, including covariables (e.g., patient characteristics, disease severity, pre-ICU HRQoL, etc.) to explore associations between the physical, cognitive, and mental health domains of PICS and changes in HRQoL at 3 and 12 months post-ICU. At 3 months (n = 3368), physical health problems (β = -0.04 [95% CI, -0.06 to 0.02]; p < 0.001), cognitive health problems (β = -0.05 [95% CI, -0.09 to -0.02]; p < 0.001), and mental health problems (β = -0.08 [95% CI, -0.10 to -0.05]; p < 0.001) were negatively associated with changes in HRQoL. Also, at 12 months (n = 2950), physical health problems (β = -0.06 [95% CI, -0.08 to -0.03]; p < 0.001), cognitive health problems (β = -0.04 [95% CI, -0.08 to -0.01]; p < 0.015), and mental health problems (β = -0.06 [95% CI, -0.08 to -0.03]; p < 0.001) were negatively associated with changes in HRQoL.

Conclusions: PICS symptoms in the physical, cognitive, and mental domains are all negatively associated with changes in HRQoL at 3 and 12 months post-ICU. At 3 months, PICS symptoms in the mental domain seem to have the largest negative associations. At 12 months, the associations of PICS in the mental and physical domains are the same. This implies that daily ICU care and follow-up care should focus on preventing and mitigating health problems across all three PICS domains to prevent a decrease in HRQoL.

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重症监护后综合征的身体、认知和心理健康领域与生活质量之间的关系：一项纵向多中心队列研究。

目的探讨重症监护室入院后身体、认知和精神方面的重症监护后综合征（PICS）与健康相关生活质量（HRQoL）变化之间的关系：设计：纵向前瞻性多中心队列研究：干预措施：无：测量和主要结果在重症监护病房入院时、重症监护病房术后 3 个月和 12 个月，患者填写了有关身体健康问题、认知健康问题、心理健康问题和 HRQoL 的有效问卷。对身体健康领域（身体问题和疲劳）和心理健康领域（焦虑、抑郁和创伤后应激障碍）进行了综合评分。进行调整后的多变量线性回归分析，包括协变量（如患者特征、疾病严重程度、重症监护室前 HRQoL 等），以探讨 PICS 的身体、认知和心理健康领域与重症监护室术后 3 个月和 12 个月 HRQoL 变化之间的关系。在3个月时（n = 3368），身体健康问题（β = -0.04 [95% CI, -0.06 to 0.02]; p < 0.001）、认知健康问题（β = -0.05 [95% CI, -0.09 to -0.02]; p < 0.001）和心理健康问题（β = -0.08 [95% CI, -0.10 to -0.05]; p < 0.001）与 HRQoL 的变化呈负相关。此外，在 12 个月时（n = 2950），身体健康问题（β = -0.06 [95% CI, -0.08 to -0.03]；p < 0.001）、认知健康问题（β = -0.04 [95% CI, -0.08 to -0.01]；p < 0.015）和心理健康问题（β = -0.06 [95% CI, -0.08 to -0.03]；p < 0.001）与 HRQoL 的变化呈负相关：结论：PICS在身体、认知和精神领域的症状均与ICU术后3个月和12个月的HRQoL变化呈负相关。在 3 个月时，精神领域的 PICS 症状似乎具有最大的负相关。12 个月时，精神和身体领域的 PICS 相关性相同。这意味着重症监护室的日常护理和后续护理应侧重于预防和减轻所有三个 PICS 领域的健康问题，以防止 HRQoL 的下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical Care Medicine 医学-危重病医学

CiteScore

16.30

自引率

5.70%

发文量

728

审稿时长

2 months

期刊介绍： Critical Care Medicine is the premier peer-reviewed, scientific publication in critical care medicine. Directed to those specialists who treat patients in the ICU and CCU, including chest physicians, surgeons, pediatricians, pharmacists/pharmacologists, anesthesiologists, critical care nurses, and other healthcare professionals, Critical Care Medicine covers all aspects of acute and emergency care for the critically ill or injured patient. Each issue presents critical care practitioners with clinical breakthroughs that lead to better patient care, the latest news on promising research, and advances in equipment and techniques.