重症监护幸存者报告的症状:对幸存者症状的纵向研究。

Intensive care survivor-reported symptoms: a longitudinal study of survivors' symptoms.

机构信息

Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Department of Post-operative and Critical Care, Division of Emergencies and Critical Care Oslo University Hospital, Rikshospitalet, Oslo, Norway.

出版信息

Nurs Crit Care. 2018 Jan;23(1):48-54. doi: 10.1111/nicc.12330. Epub 2017 Dec 15.

Abstract

BACKGROUND

There is growing interest in potential long-term outcomes following intensive care, but few researchers have studied the prevalence of multiple symptoms or the association between pain and other symptoms.

AIMS

To investigate the prevalence of anxiety, depression, fatigue, sleep disturbance and post-traumatic stress symptoms (PTSS) among intensive care survivors 3 months and 1 year after being discharged from an intensive care unit (ICU) and to determine whether pain is associated with higher prevalence of these symptoms 3 months and 1 year after ICU stay.

STUDY DESIGN

Exploratory, longitudinal cohort of intensive care survivors from two mixed ICUs in a tertiary referral hospital in Norway.

METHODS

Intensive care survivors completed surveys at 3 months (n = 118) and 1 year (n = 89) after ICU discharge. Clinical Trials: NCT02279212.

RESULTS

Prevalence rates of intensive care survivors' symptoms were pain 58 (49·2%), anxiety/depression 24/118 (20·8%), fatigue 18/118(15·3%), PTSS 15 (12·8%) and sleep disturbance 58/118 (49·2%) at 3 months after ICU discharge (n = 118). Prevalence rates at 1 year (n = 89) changed only slightly to pain 34 (38·2%), anxiety/depression 17 (20·0%), fatigue 12 (13·8%), PTSS 13 (15·1%) and sleep disturbance 40/89 (46·5%). Associations were strong between pain and presence of sleep disturbance, anxiety/depression, PTSS and fatigue.

CONCLUSIONS

Intensive care survivors have multiple symptoms and the prevalence rates of these symptoms remained almost unchanged from 3 months to 1 year after ICU discharge. The presence of pain was associated with high odds for the presence of sleep disturbance, anxiety/depression, PTSS and fatigue, compared to a no-pain group. ICU survivors may benefit from targeted interventions designed to alleviate the symptom burden.

RELEVANCE TO CLINICAL PRACTICE

Knowledge about ICU survivor's prevalence and risk for having multiple symptoms may help health care professionals to give better care, if needed, to the ICU survivors.

摘要

背景

人们对重症监护后潜在的长期结果越来越感兴趣,但很少有研究人员研究过多种症状的患病率,或疼痛与其他症状之间的关系。

目的

调查重症监护病房(ICU)幸存者在离开 ICU 后 3 个月和 1 年时焦虑、抑郁、疲劳、睡眠障碍和创伤后应激症状(PTSS)的患病率,并确定疼痛是否与 ICU 后 3 个月和 1 年时这些症状的更高患病率相关。

研究设计

这是一项在挪威一家三级转诊医院的两家混合 ICU 中进行的探索性、纵向 ICU 幸存者队列研究。

方法

ICU 幸存者在离开 ICU 后 3 个月(n=118)和 1 年(n=89)时完成了调查。临床试验:NCT02279212。

结果

ICU 幸存者在离开 ICU 后 3 个月时出现以下症状的患病率为:疼痛 58(49.2%)、焦虑/抑郁 24/118(20.8%)、疲劳 18/118(15.3%)、PTSS 15(12.8%)和睡眠障碍 58/118(49.2%)(n=118)。1 年后(n=89)的患病率变化不大,疼痛为 34(38.2%)、焦虑/抑郁 17(20.0%)、疲劳 12(13.8%)、PTSS 13(15.1%)和睡眠障碍 40/89(46.5%)。疼痛与睡眠障碍、焦虑/抑郁、PTSS 和疲劳的存在之间存在很强的关联。

结论

重症监护幸存者存在多种症状,且这些症状的患病率在离开 ICU 后 3 个月至 1 年期间几乎没有变化。与无疼痛组相比,疼痛的存在与睡眠障碍、焦虑/抑郁、PTSS 和疲劳的存在高度相关。重症监护幸存者可能受益于旨在减轻症状负担的靶向干预措施。

临床意义

了解 ICU 幸存者的患病率和出现多种症状的风险,可以帮助医护人员在需要时为 ICU 幸存者提供更好的护理。

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