危重病幸存者的情绪后遗症：一项长期回顾性研究。

Emotional sequelae among survivors of critical illness: a long-term retrospective study.

机构信息

1st Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.

出版信息

Eur J Anaesthesiol. 2013 Mar;30(3):111-8. doi: 10.1097/EJA.0b013e32835dcc45.

DOI:10.1097/EJA.0b013e32835dcc45

PMID:23358098

Abstract

CONTEXT

Treatment in an ICU can be stressful and traumatic for patients, and can lead to various physical, psychological and cognitive sequelae.

OBJECTIVES

The aim of the study was to assess the influence of the social, economic and working status of individuals in regard to long-term anxiety and depression among ICU convalescents.

DESIGN

Retrospective, cross-sectional, 5-year survey between 2005 and 2009.

SETTING

The general ICUs of two hospitals in Lublin (Poland): the Teaching Hospital, Medical University of Lublin and the District Hospital.

PATIENTS

All adults surviving an ICU stay of more than 24 h were eligible. In December 2010, 533 questionnaires were sent to discharged ICU survivors, and 195 (36.6%) were returned. One hundred and eighty-six patients were enrolled in the study. Patients with brain injuries were excluded.

MAIN OUTCOME MEASURES

The questionnaire consisted of the Hospital Anxiety and Depression Scale (HADS); questions defining social, economic and working status before and after intensive care stay, health status before intensive care stay, as well as questions about memories and readmissions to intensive care were included.

RESULTS

According to HADS, 34.4% patients had an anxiety disorder and 27.4% were depressed. There was a strong positive correlation between anxiety and depression (r = +0.726, P<0.001). Better material and housing conditions correlated with lower anxiety and depression rates. Acute Physiology and Chronic Health Evaluation II scores on admission positively correlated with both anxiety (r =+0.187; P=0.011) and depression (r = +0.239; P=0.001). A negative correlation between health status before intensive care admission and HADS scores was observed (anxiety rs = -0.193; P=0.008; depression rs = -0.227; P=0.002); better health resulted in less anxiety and depression disorders.

CONCLUSION

Adverse social and economic status is associated with higher rates of anxiety and depression following ICU stay.

摘要

背景

在 ICU 接受治疗对患者来说可能是充满压力和创伤的，并且可能导致各种身体、心理和认知方面的后遗症。

目的

本研究旨在评估个体的社会、经济和工作状况对 ICU 康复者长期焦虑和抑郁的影响。

设计

2005 年至 2009 年期间进行的回顾性、横断面、5 年调查。

地点

波兰卢布林的两家医院的综合 ICU：卢布林医科大学教学医院和地区医院。

患者

符合条件的是 ICU 住院时间超过 24 小时并存活的所有成年人。2010 年 12 月，向出院的 ICU 幸存者发送了 533 份问卷，其中 195 份（36.6%）被退回。共有 186 名患者入组研究。排除脑损伤患者。

主要观察指标

问卷包括医院焦虑和抑郁量表（HADS）；包括 ICU 前后的社会、经济和工作状况、ICU 前的健康状况、记忆和再次入住 ICU 的问题。

结果

根据 HADS，34.4%的患者患有焦虑症，27.4%的患者患有抑郁症。焦虑和抑郁之间存在强烈的正相关（r = +0.726，P<0.001）。更好的物质和住房条件与较低的焦虑和抑郁发生率相关。入院时急性生理学和慢性健康评估 II 评分与焦虑（r = +0.187；P=0.011）和抑郁（r = +0.239；P=0.001）呈正相关。入院前的健康状况与 HADS 评分呈负相关（焦虑 rs = -0.193；P=0.008；抑郁 rs = -0.227；P=0.002）；更好的健康状况导致更少的焦虑和抑郁障碍。