Cognitive Function 3 and 12 Months After ICU DischargeA Prospective Cohort Study

被引:26
作者
Estrup, Stine [1 ]
Kjer, Cilia K. W. [1 ]
Vilhelmsen, Frederik [1 ]
Poulsen, Lone M. [1 ]
Gogenur, Ismail [2 ]
Mathiesen, Ole [1 ]
机构
[1] Zealand Univ Hosp, Ctr Anaesthesiol Res, Dept Anesthesiol, Koge, Denmark
[2] Zealand Univ Hosp, Ctr Surg Sci, Dept Gastrointestinal Surg, Koge, Denmark
关键词
aftercare; cognitive dysfunction; intensive care; postintensive care syndrome; rehabilitation; INTENSIVE-CARE-UNIT; CRITICAL ILLNESS; ECONOMIC-IMPLICATIONS; REPEATABLE BATTERY; IMPAIRMENT; SURVIVORS; REHABILITATION; DISABILITY; DELIRIUM; RBANS;
D O I
10.1097/CCM.0000000000003391
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: Studies have shown impaired cognitive function after ICU discharge. We aimed to describe long-term cognitive function in Danish ICU patients. Design: Prospective cohort study. Setting: Single-center ICU at Zealand University Hospital, KOge, Denmark. Patients: Adult patients admitted for over 24 hours. Intervention: Three and 12 months after discharge, the patients were visited at home and tested with the Repeatable Battery for the Assessment of Neuropsychological Status. Measurements and Main Results: We included 161 patients, 79 patients had a 3-month and 53 a 12-month follow-up visit. The primary reasons for not being visited at 3-month were death (44 patients), decline (26 patients), or transferal to another ICU (6 patients). Visited patients were median 67 years old (interquartile range, 59-73), had a median Acute Physiology and Chronic Health Evaluation score of 20 (interquartile range, 16-26), 58% were on a ventilator, and 30% were surgical patients. The mean Repeatable Battery for the Assessment of Neuropsychological Status score was 67 (sd, 21), compared with a normal value of 100 (15). A total of 57% had Repeatable Battery for the Assessment of Neuropsychological Status scores corresponding to moderate traumatic brain injury, 46% scored corresponding to light Alzheimer's disease, and 73% corresponding to mild cognitive impairment. After 12 months, the Repeatable Battery for the Assessment of Neuropsychological Status was still reduced (71 [25]). We examined protective and risk factors using multiple linear regression and found protective effects of being employed before admission (p = 0.0005) or being admitted from a surgical ward (p = 0.019). Conclusions: In this prospective cohort study of Danish ICU patients, we found significantly reduced cognitive function for intensive care patients 3 and 12 months after discharge.
引用
收藏
页码:E1121 / E1127
页数:7
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