Department of Anesthesiology, Centre of Anaesthesiological Research, Zealand University Hospital, Køge, Denmark.
Department of Gastrointestinal Surgery, Center for Surgical Science, Zealand University Hospital, Køge, Denmark.
Crit Care Med. 2018 Dec;46(12):e1121-e1127. doi: 10.1097/CCM.0000000000003391.
Studies have shown impaired cognitive function after ICU discharge. We aimed to describe long-term cognitive function in Danish ICU patients.
Prospective cohort study.
Single-center ICU at Zealand University Hospital, Køge, Denmark.
Adult patients admitted for over 24 hours.
Three and 12 months after discharge, the patients were visited at home and tested with the Repeatable Battery for the Assessment of Neuropsychological Status.
We included 161 patients, 79 patients had a 3-month and 53 a 12-month follow-up visit. The primary reasons for not being visited at 3-month were death (44 patients), decline (26 patients), or transferal to another ICU (6 patients). Visited patients were median 67 years old (interquartile range, 59-73), had a median Acute Physiology and Chronic Health Evaluation score of 20 (interquartile range, 16-26), 58% were on a ventilator, and 30% were surgical patients. The mean Repeatable Battery for the Assessment of Neuropsychological Status score was 67 (SD, 21), compared with a normal value of 100 (15). A total of 57% had Repeatable Battery for the Assessment of Neuropsychological Status scores corresponding to moderate traumatic brain injury, 46% scored corresponding to light Alzheimer's disease, and 73% corresponding to mild cognitive impairment. After 12 months, the Repeatable Battery for the Assessment of Neuropsychological Status was still reduced (71 [25]). We examined protective and risk factors using multiple linear regression and found protective effects of being employed before admission (p = 0.0005) or being admitted from a surgical ward (p = 0.019).
In this prospective cohort study of Danish ICU patients, we found significantly reduced cognitive function for intensive care patients 3 and 12 months after discharge.
研究表明,重症监护病房(ICU)出院后认知功能受损。本研究旨在描述丹麦 ICU 患者的长期认知功能。
前瞻性队列研究。
丹麦哥本哈根州的 Zealand 大学医院单中心 ICU。
入住 ICU 超过 24 小时的成年患者。
出院后 3 个月和 12 个月,患者在家中接受重复认知评估电池测试。
共纳入 161 例患者,其中 79 例在 3 个月时进行了随访,53 例在 12 个月时进行了随访。3 个月时未进行随访的主要原因是死亡(44 例)、病情恶化(26 例)或转至其他 ICU(6 例)。接受随访的患者中位年龄为 67 岁(四分位间距 59-73 岁),急性生理学和慢性健康评估评分中位数为 20 分(四分位间距 16-26 分),58%的患者使用呼吸机,30%为外科患者。重复认知评估电池的平均得分是 67(标准差 21),而正常值为 100(15)。共有 57%的患者的重复认知评估电池得分对应中度创伤性脑损伤,46%对应轻度阿尔茨海默病,73%对应轻度认知障碍。12 个月后,重复认知评估电池仍有下降(71[25])。我们使用多元线性回归检查了保护和危险因素,发现入院前有工作(p = 0.0005)或从外科病房入院(p = 0.019)是保护因素。
在这项丹麦 ICU 患者的前瞻性队列研究中,我们发现 ICU 患者出院后 3 个月和 12 个月时认知功能显著下降。