{"title":"患者和家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。","authors":"","doi":"10.1016/j.medine.2024.04.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>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.</p></div><div><h3>Design</h3><p>Prospective, observational cohort (March 2018–2023), follow-up at three months and one year.</p></div><div><h3>Setting</h3><p>14-bed polyvalent Intensive Care Unit (ICU), Level II Hospital.</p></div><div><h3>Patients or participants</h3><p>265 patients and 209 relatives. Inclusion criteria patients: age > 18 years, mechanical ventilation > 48 h, ICU stay > 5 days, delirium, septic shock, acute respiratory distress syndrome, cardiac arrest. Inclusion criteria family: those who attended.</p></div><div><h3>Interventions</h3><p>Follow-up 3 months and 1 year after hospital discharge.</p></div><div><h3>Main variables of interest</h3><p>Patients: sociodemographic, clinical, evolutive, physical, psychological and cognitive alterations, dependency degree and quality of life. Main caregivers: mental state and physical overload.</p></div><div><h3>Results</h3><p>64.9% PICS-P, no differences between groups. COVID patients more physical alterations than non-COVID (<em>P</em> = .028). These more functional deterioration (<em>P</em> = .005), poorer quality of life (<em>P</em> = .003), higher nutritional alterations (<em>P</em> = .004) and cognitive deterioration (<em>P</em> < .001). 19.1% PICS-F, more frequent in relatives of non-COVID patients (17.6% vs. 5.5%; <em>P</em> = .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).</p></div><div><h3>Conclusions</h3><p>Prevalence PICS-P and PICS-F between both cohorts was similar. Main factors associated with the development of SPCI-P were: higher comorbidity, delirium, midazolan, inclusion for more than one reason and during the first years.</p></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 8","pages":"Pages 445-456"},"PeriodicalIF":0.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Postintensive care syndrome in patients and family members. Analysis of COVID-19 and non-COVID-19 cohorts, with face-to-face follow-up at three months and one year\",\"authors\":\"\",\"doi\":\"10.1016/j.medine.2024.04.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>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.</p></div><div><h3>Design</h3><p>Prospective, observational cohort (March 2018–2023), follow-up at three months and one year.</p></div><div><h3>Setting</h3><p>14-bed polyvalent Intensive Care Unit (ICU), Level II Hospital.</p></div><div><h3>Patients or participants</h3><p>265 patients and 209 relatives. Inclusion criteria patients: age > 18 years, mechanical ventilation > 48 h, ICU stay > 5 days, delirium, septic shock, acute respiratory distress syndrome, cardiac arrest. Inclusion criteria family: those who attended.</p></div><div><h3>Interventions</h3><p>Follow-up 3 months and 1 year after hospital discharge.</p></div><div><h3>Main variables of interest</h3><p>Patients: sociodemographic, clinical, evolutive, physical, psychological and cognitive alterations, dependency degree and quality of life. Main caregivers: mental state and physical overload.</p></div><div><h3>Results</h3><p>64.9% PICS-P, no differences between groups. COVID patients more physical alterations than non-COVID (<em>P</em> = .028). These more functional deterioration (<em>P</em> = .005), poorer quality of life (<em>P</em> = .003), higher nutritional alterations (<em>P</em> = .004) and cognitive deterioration (<em>P</em> < .001). 19.1% PICS-F, more frequent in relatives of non-COVID patients (17.6% vs. 5.5%; <em>P</em> = .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).</p></div><div><h3>Conclusions</h3><p>Prevalence PICS-P and PICS-F between both cohorts was similar. Main factors associated with the development of SPCI-P were: higher comorbidity, delirium, midazolan, inclusion for more than one reason and during the first years.</p></div>\",\"PeriodicalId\":94139,\"journal\":{\"name\":\"Medicina intensiva\",\"volume\":\"48 8\",\"pages\":\"Pages 445-456\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicina intensiva\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2173572724000821\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina intensiva","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2173572724000821","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Postintensive care syndrome in patients and family members. Analysis of COVID-19 and non-COVID-19 cohorts, with face-to-face follow-up at three months and one year
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 h, 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 = .028). These more functional deterioration (P = .005), poorer quality of life (P = .003), higher nutritional alterations (P = .004) and cognitive deterioration (P < .001). 19.1% PICS-F, more frequent in relatives of non-COVID patients (17.6% vs. 5.5%; P = .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, midazolan, inclusion for more than one reason and during the first years.