Neuropsychiatric outcome in subgroups of Intensive Care Unit survivors: Implications for after-care

J Crit Care. 2020 Feb:55:171-176. doi: 10.1016/j.jcrc.2019.11.006. Epub 2019 Nov 12.

Abstract

Purpose: Poor neuropsychiatric outcomes are common in survivors of critical illness but it is unclear what patient groups to target for interventions to improve mental health. We compared anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms and health-related quality of life (HrQoL) across different subgroups of Intensive Care Unit (ICU) survivors.

Materials and methods: A single-center cohort study was conducted in a mixed-ICU in the Netherlands among survivors of an ICU admission ≥48 h (n = 1730). Survivors received a survey one year after discharge, containing the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES/IES-R), and EQ-5D (response rate of 67%). Neuropsychiatric symptoms and quality of life were evaluated in a priori defined subgroups, by chi-square tests and Mann-Whitney U tests.

Results: Symptoms of anxiety (HADS anxiety ≥8), depression (HADS depression ≥8), and PTSD (IES ≥35; IES-R ≥ 1.6) were reported by 34%, 33%, and 19% of ICU survivors, with a median HrQoL utility score of 0.81 (IQR:0.65-1.00). These figures were similar for survivors of ARDS, sepsis, severe multiple organ failure (SOFA>11), or ICU stay ≥7 days.

Conclusions: This underlines the importance of prevention and treatment for neuropsychiatric symptoms in ICU survivors in general, not only in specific patient groups.

Keywords: Anxiety; Critical illness; Depression; Intensive care unit; Posttraumatic stress disorder; Quality of life.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / psychology*
  • Critical Illness / psychology*
  • Depression / psychology*
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Male
  • Mental Health
  • Middle Aged
  • Netherlands
  • Patient Discharge
  • Prospective Studies
  • Psychometrics
  • Quality of Life*
  • Stress Disorders, Post-Traumatic / psychology*
  • Surveys and Questionnaires
  • Survivors / psychology
  • Young Adult