Activities of daily living status and psychiatric symptoms after discharge from an intensive care unit: a single‐center 12‐month longitudinal prospective study

Abstract

Aim In post‐intensive care syndrome (PICS), long‐term survivors of critical illness present various physical and mental symptoms that can persist for years after discharge. Post‐intensive care syndrome in Japan has not been well described, so this study aims to elucidate its epidemiology. Methods We undertook a single‐center prospective longitudinal cohort study in a mixed intensive care unit (ICU) in a Japanese tertiary hospital. Adult patients emergently admitted to the ICU were eligible for inclusion in the study. To assess activity of daily living (ADL) status and psychiatric symptoms, we posted a questionnaire at 3 and 12 months after discharge from the ICU. We evaluated ADL status, anxiety, depression, and post‐traumatic stress disorder symptoms using the Barthel index, Hospital Anxiety and Depression Scale, and Impact of Event Scale − Revised, respectively. Results Enrolled in this study were 204 patients. We received responses from 117/147 (80%) and 74/98 (76%) patients at 3 and 12 months, respectively. At 3 months, the prevalence of ADL disability, anxiety, depression, and post‐traumatic stress disorder symptoms was 32%, 42%, 48%, and 20%, respectively. At 12 months, the prevalence was 22%, 33%, 39%, and 21%, respectively. The prevalence of any symptoms was 66% at 3 months and 55% at 12 months. Barthel index score at 12 months was improved significantly from that at 3 months. Hospital Anxiety and Depression Scale and Impact of Event Scale − Revised scores at 12 months showed no improvement. Conclusions At 3 and 12 months after ICU discharge, over half of our Japanese patients suffered ADL disability and/or psychiatric symptoms. The ADL disability improved at 1 year, but psychiatric symptoms did not.

Prevalence of and risk factors for post-intensive care syndrome: Multicenter study of patients living at home after treatment in 12 Japanese intensive care units, SMAP-HoPe study

“…This may have contributed to our findings. Additionally, this difference in populations could also have contributed to the higher prevalence of PTSD in a recent Japanese ICU study, which analyzed only emergency-admitted patients [ 10 ].…”

“…Recently, Wu and colleagues [ 9 ] evaluated the prevalence of mental health issues in post-ICU patients in Hong Kong. In Japan, in a recent single-center cohort study, Shima and colleagues [ 10 ] found that 3 and 12 months after ICU discharge, over half of the Japanese patients admitted to the emergency unit experienced impaired activities of daily living and/or psychiatric symptoms. They reported that the prevalence of PTSD was 20% at 12 months post-ICU discharge.…”

Incidence and Risk Factors of Worsened Activities of Daily Living Status Three Months after Intensive Care Unit Discharge among Critically Ill Patients: A Prospective Cohort Study

“…We also evaluated BI scores before ICU admission (baseline) from information gained from patients’ proxies. The main results of the W-PICS study have been previously reported elsewhere [ 3 ]. The present sub-analysis includes all patients (no missing data) of BI both before ICU admission and three months after ICU discharge, and who can be evaluated to ascertain whether there was worsened ADL status between before and after their admission to ICU.…”

“…Physical and cognitive impairment often leads to functional disability, such as adversely affected activity of daily living (ADL) status. Approximately 30% of survivors from critical illness were reported to have reduced ADL status [ 2 , 3 ]. Early prediction of impairment of ADL status after intensive care unit (ICU) discharge may facilitate the implementation of preventive measures and help patients and their families better anticipate the post-ICU course.…”

Activities of daily living and psychiatric symptoms after intensive care unit discharge among critically ill patients with or without tracheostomy: a single center longitudinal study

“…This is a sub‐analysis of Wakayama post‐intensive care syndrome (W‐PICS) study, a single center prospective longitudinal study. 14 W‐PICS‐study was approved by the Wakayama Medical University Ethics Committee (approval no. 1864), and was registered to the UMIN Clinical Trial Registry, UMIN000023743 (Registered on September 1, 2016, https://upload.umin.ac.jp/cgi‐open‐bin/ctr_e/ctr_view.cgi?recptno=R000027346 ).…”