Post ICU syndrome among survivors from respiratory critical illness. A prospective study

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.