Journal: |
egyptian journal of chest diseases and tuberculosis
Wolters Kluwer - Medknow
|
Volume: |
|
Abstract: |
Context Post-ICU syndrome (PICS) is a common impairment
that develops after critical illness and persists after discharge.
It is considered when a new or worsening impairment in
physical, cognitive, or mental status develops among
survivors from critical illness.
Aim To assess the prevalence of PICS and to define the
profile of patients at risk of each domain.
Patients and methods A total of 420 critically ill patients
were assessed at the time of ICU discharge for presence of
one or more domains of PICS: cognitive dysfunction,
psychiatric impairment, and physical disability.
Results A total of 220 (52.4%) patients without preexisting
impairment developed one or more PICS forms. Half of the
participants developed cognitive impairment, 14.29%
developed depression, 26.19 developed anxiety, and 35.71%
experienced both muscle weakness and impaired balance.
PICS presented in three different patterns: pattern A, with one
domain, in which 2.38% presented with either cognitive or
psychiatric affection; pattern B, with two (19.05%) domains,
where 80 patients had cognitive dysfunction, combined with
physical affection in 30 patients and psychiatric impairment in
50 patients; and pattern C, with all PICS domains (28.57%Multivariate analysis was used to detect independent
predictors associated with each domain of PICS.
Conclusion Survivors from critical illness should be screened
for different domains of PICS. Cognitive impairment was
evident in those with prolonged duration of mechanical
ventilation (MV), delirium, stroke, and hypotension.
Psychiatric impairment was evident in females with prolonged
sedation and duration of MV, delirium, and hypoglycemia.
Physical impairments were evident in those with sepsis,
undernutrition, and prolonged duration of MV.
|
|
|