A Prospective Investigation of Long-Term Cognitive Impairment and Psychological Distress in Moderately Versus Severely Injured Trauma Intensive Care Unit Survivors Without Intracranial Hemorrhage

Jackson, James C.; Archer, Kristin R.; Bauer, Rebecca; Abraham, Christine M.; Song, Yanna; Greevey, Robert; Guillamondegui, Oscar D.; Ely, E. Wesley; Obremskey, William T.

doi:10.1097/ta.0b013e3182151961

Cited by 42 publications

(30 citation statements)

References 34 publications

(32 reference statements)

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“…Among these patients, increasing duration of delirium during acute critical illness in the ICU was an independent predictor of worse cognitive performance at follow-up, after adjustment for age, education, preexisting cognitive function, severe sepsis, and exposure to sedatives in the ICU (8). Similar cognitive testing of 108 1-year survivors of acute critical illness after trauma (without intracranial hemorrhage) showed impairments in about one-half of the subjects, although nearly one-half of the study cohort had returned to either fulltime or part-time work at the time of assessment (20). These studies and others indicate that patients returning to the ORIGINAL RESEARCH community after treatment for acute critical illness often experience subclinical cognitive impairment and that the duration of delirium in the ICU is among factors influencing the risk of this long-term outcome.…”

Section: Discussionmentioning

confidence: 88%

Risk Factors for Long-Term Brain Dysfunction after Chronic Critical Illness

Hope

Wallenstein

et al. 2013

Annals ATS

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Rationale: Factors associated with long-term brain dysfunction (LTBD) in survivors of chronic critical illness (CCI) have not been explored but may be important for clinical practice and planning by patients, families, and providers.Objectives: To identify risk factors for LTBD after treatment for CCI and to explore the association between acute delirium and coma during hospital treatment and LTBD.Methods: A prospective cohort study of adults admitted to a respiratory care unit for treatment of CCI. Measurements and Main Results:Using the Confusion Assessment Method for ICU and the Richmond Agitation and Sedation Scale, we evaluated patients for delirium and coma during their hospital treatment for CCI. We collected data on other potential risk factors for LTBD by prospectively reviewing the patients' medical records and interviewing surrogates. We contacted survivors by telephone at 6 months after discharge to assess brain function using the telephone Confusion Assessment Method. Among 385 patients treated for CCI, 213 (56.1%) were dead at 6 months, and 108 of 167 (64.7%) of survivors were impaired. We used multinomial logistic regression in which the outcomes were (1) death, (2) brain dysfunction, and (3) survival without LTBD. Older patients, patients with higher Acute Physiology Score, and those with multiple complications during treatment for CCI were more likely to have LTBD. Acute brain dysfunction during hospital treatment was also associated with an increased risk of LTBD (odds ratio, 2.14; 95% confidence interval, 1.02-4.52).Conclusions: LTBD after treatment for CCI is associated with brain dysfunction during such treatment as well as with older age and higher severity of illness of the patients.

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Section: Discussionmentioning

confidence: 88%

Risk Factors for Long-Term Brain Dysfunction after Chronic Critical Illness

Hope

Wallenstein

et al. 2013

Annals ATS

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“…To our knowledge, no study has attempted to determine if a mental health disorder is a prognostic factor in patients undergoing surgery for femoroacetabular impingement or for any orthopaedic issue in an active-duty population. The trauma, spine, arthroplasty, and hand literature have shown poor outcomes in civilian patients with mental health diagnoses such as PTSD, depression, and anxiety [11][12][13][14] . This raises the question as to whether an interventional program to improve mental health might be beneficial prior to treating patients surgically for femoroacetabular impingement or other musculoskeletal conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Hoge et al reported that up to 29% of service members screened positive for posttraumatic stress disorder (PTSD), anxiety, or depression after deployment to Iraq 10 . Studies in the trauma, spine, and hand literature have also shown poor outcomes in civilian patients with mental health diagnoses [11][12][13] . Variable outcomes have been reported for arthroplasty 14,15 .…”

mentioning

confidence: 99%

Mental Health Medication Use Correlates with Poor Outcome After Femoroacetabular Impingement Surgery in a Military Population

Ernat

Song

Brugman

et al. 2015

The Journal of Bone and Joint Surgery

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“…Čimbenici rizika za nastanak psihijatrijske bolesti [npr, tjeskoba, depresija, posttraumatski stresni poremećaj] slični su onima za kognitivne [10,11,12]. Za nastanak sindroma rizik povećavaju postojeća anksioznost i depresija, kao i ženski spol, starosna dob <50 godina, niži stupanj obrazovanja, već postojeća invalidnost/nezaposlenost, uživanje alkohola, primjena sedativa i analgezije [13].…”

Section: Psihički čImbeniciunclassified

Sindrom postintenzivne skrbi Post-intensive care syndrome

Kovačević

Kalauz

Krikšić

et al. 2017

SG/NJ

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SažetakPozadina: Sindrom postintenzivne skrbi (engl. PICS-post-intenzive care syndrome) definira se kao pogoršanje kognitivnih, psihičkih i fizičkih funkcija kod bolesnika koji su preboljeli bolesti s visokim stupnjem smrtnog ishoda u jedinici intenzivnog liječenja (JIL). Precizna prevalencija sindroma je nepoznata: prema publiciranim rezultatima procjenjuje se da se kod jedne četvrtine do jedne polovine preživjelih verificira postojanje nekih od navedenih smetnji. Cilj: Cilj je preglednog članka iznaći zaključke provedenog empirijskog istraži-vanja koje istražuje učestalost kognitivnih, psihičkih i fizičkih simptoma u bolesnika nakon otpuštanja iz jedinice intenzivnog liječenja. Istraživanje je trostupanjsko te se ispituju pokazatelji sindroma PICS-a, koji su čimbenici rizika povezani s povećanom incidencijom nastanka sindroma postintenzivne skrbi, i ispitati koje metode i terapijski postupci smanjuju rizik u nastanku PICS-a. Rezultati: Simptomi su sindroma postintenzivne skrbi slabost mišića, slabija pokretljivost, lošija koncentracija, slabljenje memorije, umor, anksioznost i depresivno raspoloženje. Čimbenici rizika nastanka sindroma postintenzivne skrbi neuromuskularni su poremećaji, demencija, psihijatrijske bolesti, JIL-specifični čimbenici, uporaba mehaničke ventilacije, delirij, sepsa i sindrom akutnog respiratornog distresa. Učestalost nastanka PICS-a može se smanjiti uporabom metoda/postupaka koji smanjuju vremensko trajanje sedacije i ubrzavaju ranu fizičku rehabilitaciju. Zaključak: Sindrom se verificira kad se pronađu novi ili utvrdi postojanje pogoršanja znakova i simptoma jednog ili više od triju organskih sustava: kognitivni, psihički i fizički. Identifikacija svake navedene komponente potvrđuje se testiranjima. Znakovi i simptomi sindroma postintenzivne skrbi mogu se poboljšati tijekom prvih 6 do 12 mjeseci nakon otpuštanja iz jedinice intenzivnog liječenja. Međutim, kod mnogih pacijenata, deficiti perzistiraju godinama. PICS je povezan s nemogućnošću povratka na posao i smanjenom kvalitetom stupnja života, kao i povećanim rizikom od smrti tijekom nekoliko sljedećih godina. AbstractBackground: Post-intensive care syndrome (PICS) is defined as worsening of cognitive, psychological and physiological functions in patients with critical conditions, treated in the intensive care units (ICU). Despite the fact that the prevalence of the PICS is yet unknown, it is estimated that up to ¼ to one half of the above-mentioned patients is suffering from some of the issues associated with PICS. Previous neuromuscular disorders, dementia, psychiatric illnesses as well as ICU-specific factors, especially mechanical ventilation, delirium, sepsis and acute respiratory distress syndrome are known as risk factors for occurrence of PICS. Aim/Purpose: The aim of this systematic review is to extract conclusions from empirical data regarding different cognitive, psychological and physiological functions that the patients released from the intensive care units (ICU) are facing. The objective of this review was to deter...

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A Prospective Investigation of Long-Term Cognitive Impairment and Psychological Distress in Moderately Versus Severely Injured Trauma Intensive Care Unit Survivors Without Intracranial Hemorrhage

Cited by 42 publications

References 34 publications

Risk Factors for Long-Term Brain Dysfunction after Chronic Critical Illness

Risk Factors for Long-Term Brain Dysfunction after Chronic Critical Illness

Mental Health Medication Use Correlates with Poor Outcome After Femoroacetabular Impingement Surgery in a Military Population

Sindrom postintenzivne skrbi Post-intensive care syndrome

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