插管和未插管重症监护幸存者的心理症状与健康相关生活质量:一项多中心、前瞻性观察队列研究

IF 1.4 4区 医学 Q3 CRITICAL CARE MEDICINE Critical Care and Resuscitation Pub Date : 2024-03-01 DOI:10.1016/j.ccrj.2023.10.011
Sumeet Rai FCICM , Teresa Neeman PhD , Rhonda Brown PhD , Krishnaswamy Sundararajan FCICM , Arvind Rajamani FCICM , Michelle Miu B.Med, MD , Rakshit Panwar PhD , Mary Nourse GradCertIntCareN , Frank M.P. van Haren PhD , Imogen Mitchell PhD , Dale M. Needham MD, PhD , for the PRICE study investigators
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引用次数: 0

摘要

目的比较插管与非插管 ICU 幸存者的长期心理症状和健康相关生活质量(HRQOL).设计前瞻性、多中心观察性队列研究.地点澳大利亚四家三级内外科 ICU.参与者插管与非插管的成人 ICU 幸存者.主要结果测量主要结果:在3个月和12个月的随访中出现有临床意义的心理症状,使用创伤后应激综合征-14(Post-Traumatic Stress Syndrome-14)测量创伤后应激障碍;抑郁、焦虑压力量表-21(Depression, Anxiety Stress Scales-21)测量抑郁、焦虑和压力。次要结果:结果 在 133 名重症监护室幸存者中,54/116(47%)人在随访时至少有一种具有临床意义的心理症状(即创伤后应激障碍、焦虑、抑郁、压力)。在插管与未插管的幸存者中,分别有 26 人(39%)和 16 人(32%)在 3 个月时出现有临床意义的心理症状评分[几率比 1.4,95% 置信区间 (0.66-3.13),p = 0.38];23 人(37%)和 10 人(31%)在 12 个月时出现有临床意义的心理症状评分[几率比 1.3,95% 置信区间 (0.53-3.31),p = 0.57]。在所有幸存者中,30%的人在3个月和12个月时报告了≥中度问题,而20%的人在12个月时报告了≥中度问题。结论近二分之一(47%)的插管和非插管 ICU 幸存者在 3 个月和 12 个月的随访中报告了有临床意义的心理症状。总体而言,两组幸存者中分别有超过 30% 和超过 20% 的人在 3 个月和 12 个月后在日常活动和行动方面出现中度或更严重的问题。两组幸存者的心理症状和 HRQOL 损伤情况相似。
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Psychological symptoms and health-related quality of life in intubated and non-intubated intensive care survivors: A multicentre, prospective observational cohort study

Objective

To compare long-term psychological symptoms and health-related quality of life (HRQOL) in intubated versus non-intubated ICU survivors.

Design

Prospective, multicentre observational cohort study.

Setting

Four tertiary medical-surgical ICUs in Australia.

Participants

Intubated and non-intubated adult ICU survivors.

Main outcome measures

Primary outcomes: clinically significant psychological symptoms at 3- and 12-month follow-up using Post-Traumatic Stress Syndrome-14 for post-traumatic stress disorder; Depression, Anxiety Stress Scales-21 for depression, anxiety, and stress. Secondary outcomes: HRQOL, using EuroQol-5D-5L questionnaire.

Results

Of the 133 ICU survivors, 54/116 (47 %) had at least one clinically significant psychological symptom (i.e., post-traumatic stress disorder, anxiety, depression, stress) at follow-up. Clinically significant scores for psychological symptoms were observed in 26 (39 %) versus 16 (32 %) at 3-months [odds ratio 1.4, 95 % confidence interval (0.66–3.13), p = 0.38]; 23 (37 %) versus 10 (31 %) at 12-months [odds ratio 1.3, 95 % confidence interval (0.53–3.31), p = 0.57] of intubated versus non-intubated survivors, respectively. Usual activities and mobility were the most commonly affected HRQOL dimension, with >30 % at 3 versus months and >20 % at 12-months of overall survivors reporting ≥ moderate problems. There was no difference between the groups in any of the EQ5D dimensions.

Conclusions

Nearly one-in-two (47 %) of the intubated and non-intubated ICU survivors reported clinically significant psychological symptoms at 3 and 12-month follow-ups. Overall, more than 30 % at 3-months and over 20 % at 12-months of the survivors in both groups had moderate or worse problems with their usual activities and mobility. The presence of psychological symptoms and HRQOL impairments was similar between the groups.

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来源期刊
Critical Care and Resuscitation
Critical Care and Resuscitation CRITICAL CARE MEDICINE-
CiteScore
7.70
自引率
3.40%
发文量
44
审稿时长
>12 weeks
期刊介绍: ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines. The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world. The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.
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