Watson Edward J R, Nenadlová Klára, Clancy Olivia H, Farag Mena, Nordin Naz A, Nilsen Agnes, Mehmet Ashley R T, Al-Hindawi Ahmed, Mandalia Sundhiya, Williams Lisa M, Edginton Trudi L, Vizcaychipi Marcela P
Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK.
Magill Department of Anaesthesia, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; Psychology Department, Westminster University, London, UK.
Burns. 2018 Aug;44(5):1167-1178. doi: 10.1016/j.burns.2018.04.011. Epub 2018 May 8.
An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns.
A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks.
15 patients (11M, 4F; 41±14 years; TBSA 38.4%±18.5) and comparators (11M, 4F; 40±13 years) were recruited. Burns patients reported worse QoL (Neuro-QoL Short Form v2, patient 30.1±8.2, control 38.7±3.2, p=0.0004) and cognitive function (patient composite z-score 0.01, IQR -0.11 to 0.33, control 0.13, IQR 0.47-0.73, p=0.02). Compared to estimated premorbid FSIQ, patients dropped an equivalent of 8 IQ points (p=0.002). Cognitive function negatively correlated with burn severity (rBaux score, p=0.04). QoL strongly correlated with depressive symptoms (Rho=-0.67, p=0.009) but not cognitive function.
Severe burns injuries are associated with a significant, global, cognitive deficit. Patients also report worse QoL, depression and post-traumatic stress. Perceived QoL from cognitive impairment was more closely associated with depression than cognitive impairment.
一项关于严重烧伤后长期认知障碍和生活质量（QoL）的调查。
一项原理验证、队列设计、前瞻性、观察性临床研究。招募入住烧伤重症监护病房进行有创通气的严重烧伤（>15% 体表面积）患者，并选取年龄和性别匹配的对照组成便利样本进行心理认知评估。参与者完成心理和生活质量问卷、Cogstate 电子测试组、霍普金斯言语学习、言语流畅性和连线测验任务。
招募了 15 名患者（11 名男性，4 名女性；41±14 岁；体表面积 38.4%±18.5）和对照组（11 名男性，4 名女性；40±13 岁）。烧伤患者报告生活质量较差（神经生活质量简表 v2，患者 30.1±8.2，对照组 38.7±3.2，p = 0.0004）和认知功能较差（患者综合 z 评分 0.01，四分位距 -0.11 至 0.33，对照组 0.13，四分位距 0.47 - 0.73，p = 0.02）。与预估的病前全量表智商相比，患者下降了相当于 8 个智商点（p = 0.002）。认知功能与烧伤严重程度呈负相关（rBaux 评分，p = 0.04）。生活质量与抑郁症状密切相关（Rho = -0.67，p = 0.009），但与认知功能无关。
严重烧伤与显著的、全面的认知缺陷相关。患者还报告生活质量较差、有抑郁和创伤后应激。认知障碍对生活质量的影响与抑郁的关联比与认知障碍的关联更紧密。
