Long-Term Mental Health Problems After Delirium in the ICU

被引:55
作者
Wolters, Annemiek E. [1 ]
Peelen, Linda M. [1 ,2 ]
Welling, Maartje C. [1 ,3 ]
Kok, Lotte [1 ]
de Lange, Dylan W. [1 ]
Cremer, Olaf L. [1 ]
van Dijk, Diederik [1 ]
Slooter, Arjen J. C. [1 ]
Veldhuijzen, Dieuwke S. [1 ,4 ]
机构
[1] Univ Med Ctr Utrecht, Dept Intens Care Med, Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Dept Epidemiol, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
[3] Univ Med Ctr Utrecht, Fac Med, Utrecht, Netherlands
[4] Leiden Univ, Leiden Inst Brain & Cognit, Hlth Med & Neuropsychol Unit, Inst Psychol, Leiden, Netherlands
关键词
anxiety; delirium; depression; intensive care unit; posttraumatic stress symptoms; INTENSIVE-CARE-UNIT; POSTTRAUMATIC-STRESS-DISORDER; CRITICALLY-ILL PATIENTS; CRITICAL ILLNESS; DEPRESSION SCALE; HOSPITAL ANXIETY; HIP FRACTURE; RISK-FACTORS; EVENT SCALE; SURVIVORS;
D O I
10.1097/CCM.0000000000001861
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: To determine whether delirium during ICU stay is associated with long-term mental health problems defined as symptoms of anxiety, depression, and posttraumatic stress disorder. Design: Prospective cohort study. Setting: Survey study, 1 year after discharge from a medical-surgical ICU in the Netherlands. Patients: One-year ICU survivors of an ICU admission lasting more than 48 hours, without a neurologic disorder or other condition that would impede delirium assessment during ICU stay. Interventions: None. Measurements and Main Results: One year after discharge, ICU survivors received a survey containing the Hospital Anxiety and Depression Scale with a subscale for symptoms of depression and a subscale for symptoms of anxiety, and the Impact of Event Scale 15 item measuring symptoms of posttraumatic stress disorder. Participants were classified as having experienced no delirium (n = 270; 48%), a single day of delirium (n = 86; 15%), or multiple days of delirium (n = 211; 37%) during ICU stay. Log binomial regression was used to assess the association between delirium and symptoms of anxiety, depression, and posttraumatic stress disorder. The study population consisted of 567 subjects; of whom 246 subjects (43%) reported symptoms of anxiety (Hospital Anxiety and Depression Scale with a subscale for anxiety, >= 8), and 254 (45%) symptoms of depression (Hospital Anxiety and Depression Scale with a subscale for depression, >= 8). In 220 patients (39%), the Impact of Event Scale 15 item was greater than or equal to 35, indicating a high probability of post traumatic stress disorder. There was substantial overlap between these mental health problems-63% of the subjects who scored positive for the presence of any three of the mental health problems, scored positive for all three. No association was observed between either a single day or multiple days of delirium and symptoms of anxiety, depression, or posttraumatic stress disorder. Conclusions: Although symptoms of anxiety, depression, and posttraumatic stress disorder were found to be common 1 year after critical illness, the occurrence of delirium during ICU stay did not increase the risk of these long-term mental health problems.
引用
收藏
页码:1808 / 1813
页数:6
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