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

Abstract

Few studies have examined the epidemiology of post-intensive care syndrome in Japan. This study investigated the mental health and quality of life of patients living at home in Japan after intensive care unit (ICU) discharge. Additionally, we examined whether unplanned admission to the ICU was associated with more severe post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms. An ambidirectional cohort study was conducted at 12 ICUs in Japan. Patients who stayed in the ICU for > 3 nights and were living at home for 1 year afterward were included. One year after ICU discharge, we retrospectively screened patients and performed a mail survey on a monthly basis, including the Impact of Event Scale—Revised (IER-S), the Hospital Anxiety Depression Scale (HADS), and the EuroQOL—5 Dimension (EQ-5D-L) questionnaires. Patients’ characteristics, delirium and coma status, drugs used, and ICU and hospital length of stay were assessed from medical records. Descriptive statistics and multilevel linear regression modeling were used to examine our hypothesis. Among 7,030 discharged patients, 854 patients were surveyed by mail. Of these, 778 patients responded (response rate = 91.1%). The data from 754 patients were analyzed. The median IES-R score was 3 (interquartile range [IQR] = 1‒9), and the prevalence of suspected PTSD was 6.0%. The median HADS anxiety score was 4.00 (IQR = 1.17‒6.00), and the prevalence of anxiety was 16.6%. The median HADS depression score was 5 (IQR = 2‒8), and the prevalence of depression was 28.1%. EQ-5D-L scores were lower in our participants than in the sex- and age-matched Japanese population. Unplanned admission was an independent risk factor for more severe PTSD, anxiety, and depressive symptoms. Approximately one-third of patients in the general ICU population experienced mental health issues one year after ICU discharge. Unplanned admission was an independent predictor for more severe PTSD symptoms.

Employment status and its associated factor for patients 12 months after intensive care: Secondary analysis of the SMAP-HoPe-study

“…The present study was a sub analysis of the the Survey of Multicenter Assessment with Postal questionnaire for Post-Intensive Care Syndrome (PICS) for Home Living Patients (SMAP-HoPe!study [10] and focused on is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint…”

“…The copyright holder for this this version posted December 2, 2021. ; https://doi.org/10.1101/2021.12.01.21266910 doi: medRxiv preprint employment status following ICU discharge and the factors that affect it. This analysis was nested in the SMAP-HoPe study [10]. In summary of SMAP-HoPe study, we conducted an ambidirectional study for patients living at home 12 months following ICU discharge.…”

“…The present study was a sub analysis of the the Survey of Multicenter Assessment with Postal questionnaire for Post-Intensive Care Syndrome (PICS) for Home Living Patients (SMAP-HoPe) study [10] and focused on employment status following ICU discharge and the factors that affect it. This analysis was nested in the SMAP-HoPe study [10]. In summary of SMAP-HoPe study, we conducted an ambidirectional study for patients living at home 12 months following ICU discharge.…”

“…Data from when the patients were admitted were obtained for retrospective analysis. Detailed methods were provided elsewhere in a distinct publication [10].…”

“…Twelve ICUs in Japan were included in this study. The detailed characteristics of each ICU included in the study were previously reported in the original study [10].…”