患者和亲属的重症监护后综合征。对 COVID-19 和非 COVID-19 组群进行分析,并在三个月和一年后进行面对面随访。

IF 2.7 4区 医学 Q2 CRITICAL CARE MEDICINE Medicina Intensiva Pub Date : 2024-08-01 DOI:10.1016/j.medin.2024.03.008
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引用次数: 0

摘要

目的比较两个队列(COVID和非COVID)中重症监护后患者(P-PICS)和家属/护理人员(F-PICS)综合征的患病率和概况,并分析P-PICS的风险因素.设计前瞻性、观察性队列(2018年3月至2023年),随访3个月和1年.设置14张病床的多价重症监护病房(ICU),二级医院.患者或参与者265名患者和209名亲属.患者纳入标准:年龄 18 岁,机械通气 48 小时,重症监护室住院 5 天,谵妄、脓毒性休克、急性呼吸窘迫综合征、心脏骤停。主要关注变量患者:社会人口学、临床、演变、身体、心理和认知改变、依赖程度和生活质量。主要护理人员:精神状态和身体超负荷。COVID 患者比非 COVID 患者有更多的身体改变(p = 0.028)。这些患者的功能退化更严重(p = 0.005),生活质量更差(p = 0.003),营养状况变化更大(p = 0.004),认知能力更差(p< 0.001)。19.1%的PICS-F,在非COVID患者的亲属中更为常见(17.6% vs. 5.5%;p = 0.013)。PICS-P的独立预测因素:研究的最初几年(OR:0.484)、较高的合并症(OR:1.158)、谵妄(OR:2.935)、纳入的几个原因(OR:3.171)和咪达唑仑(OR:4.265)。与出现 SPCI-P 相关的主要因素有:合并症较多、谵妄、咪达唑仑、入院原因不止一个以及入院最初几年。
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Síndrome postcuidados intensivos en pacientes y familiares. Análisis de cohortes COVID-19 y no COVID-19, con seguimiento presencial a los tres meses y al año

Objective

Compare prevalence and profile of post-intensive care patient (P-PICS) and family/caregiver (F-PICS) syndrome in two cohorts (COVID and non-COVID) and analyse risk factors for P-PICS.

Design

Prospective, observational cohort (March 2018- 2023), follow-up at three months and one year.

Setting

14-bed polyvalent Intensive Care Unit (ICU), Level II Hospital.

Patients or participants

265 patients and 209 relatives. Inclusion criteria patients: age > 18 years, mechanical ventilation > 48 hours, ICU stay > 5 days, delirium, septic shock, acute respiratory distress syndrome, cardiac arrest. Inclusion criteria family: those who attended.

Interventions

Follow-up 3 months and 1 year after hospital discharge.

Main variables of interest

Patients; sociodemographic, clinical, evolutive, physical, psychological and cognitive alterations, dependency degree and quality of life. Main caregivers: mental state and physical overload.

Results

64.9% PICS-P, no differences between groups. COVID patients more physical alterations than non-COVID (p = 0.028). These more functional deterioration (p = 0.005), poorer quality of life (p = 0.003), higher nutritional alterations (p = 0.004) and cognitive deterioration (p< 0.001). 19.1% PICS-F, more frequent in relatives of non-COVID patients (17.6% vs. 5.5%; p = 0.013). Independent predictors of PICS-P: first years of the study (OR: 0.484), higher comorbidity (OR: 1.158), delirium (OR: 2.935), several reasons for being included (OR: 3.171) and midazolam (OR: 4.265).

Conclusions

Prevalence PICS-P and PICS-F between both cohorts was similar. Main factors associated with the development of SPCI-P were: higher comorbidity, delirium, midazolam, inclusion for more than one reason and during the first years.

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来源期刊
Medicina Intensiva
Medicina Intensiva CRITICAL CARE MEDICINE-
CiteScore
2.70
自引率
20.00%
发文量
146
审稿时长
33 days
期刊介绍: Medicina Intensiva is the journal of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) and of Pan American and Iberian Federation of Societies of Intensive and Critical Care Medicine. Medicina Intensiva has become the reference publication in Spanish in its field. The journal mainly publishes Original Articles, Reviews, Clinical Notes, Consensus Documents, Images, and other information relevant to the specialty. All works go through a rigorous selection process. The journal accepts submissions of articles in English and in Spanish languages. The journal follows the publication requirements of the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE).
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