NIHR Academic Clinical Fellow in Intensive Care Medicine, Oxford Deanery, Oxford, UK.
Kadoorie Centre for Critical Care Research and Education, University of Oxford, Level 3, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
Crit Care. 2018 Nov 23;22(1):310. doi: 10.1186/s13054-018-2223-6.
Survivors of intensive care are known to be at increased risk of developing longer-term psychopathology issues. We present a large UK multicentre study assessing the anxiety, depression and post-traumatic stress disorder (PTSD) caseness in the first year following discharge from an intensive care unit (ICU).
Design: prospective multicentre follow-up study of survivors of ICU in the UK.
patients from 26 ICUs in the UK.
patients who had received at least 24 h of level 3 ICU care and were 16 years of age or older.
postal follow up: Hospital Anxiety and Depression Score (HADS) and the Post-Traumatic Stress Disorder (PTSD) Check List-Civilian (PCL-C) at 3 and 12 months following discharge from ICU.
caseness of anxiety, depression and PTSD, 2-year survival.
In total, 21,633 patients admitted to ICU were included in the study. Postal questionnaires were sent to 13,155 survivors; of these 38% (4943/13155) responded and 55% (2731/4943) of respondents passed thresholds for one or more condition at 3 or 12 months following discharge. Caseness prevalence was 46%, 40% and 22% for anxiety, depression and PTSD respectively; 18% (870/4943 patients) met the caseness threshold for all three psychological conditions. Patients with symptoms of depression were 47% more likely to die during the first 2 years after discharge from ICU than those without (HR 1.47, CI 1.19-1.80).
Over half of those who respond to postal questionnaire following treatment on ICU in the UK reported significant symptoms of anxiety, depression or PTSD. When symptoms of one psychological disorder are present, there is a 65% chance they will co-occur with symptoms of one of the other two disorders. Depression following critical illness is associated with an increased mortality risk in the first 2 years following discharge from ICU.
ISRCTN Registry, ISRCTN69112866 . Registered on 2 May 2006.
重症监护幸存者已知存在更高风险的长期精神病理学问题。我们报告了一项大型英国多中心研究，评估了从重症监护病房（ICU）出院后第一年的焦虑、抑郁和创伤后应激障碍（PTSD）病例。
设计：英国 ICU 幸存者的前瞻性多中心随访研究。
英国 26 个 ICU 的患者。
接受至少 24 小时 3 级 ICU 治疗且年龄在 16 岁或以上的患者。
邮寄随访：出院后 3 个月和 12 个月时使用医院焦虑和抑郁量表（HADS）和创伤后应激障碍检查表-平民版（PCL-C）。
焦虑、抑郁和 PTSD 的病例数，2 年生存率。
共有 21633 名 ICU 患者纳入研究。向 13155 名幸存者寄出了调查问卷；其中 38%（4943/13155）作出了回应，55%（2731/4943）的应答者在出院后 3 个月或 12 个月时通过了一个或多个条件的阈值。焦虑、抑郁和 PTSD 的病例数分别为 46%、40%和 22%；18%（870/4943 名患者）符合所有三种心理状况的病例数阈值。与没有症状的患者相比，出院后 2 年内出现抑郁症状的患者死亡风险增加 47%（HR 1.47，95%CI 1.19-1.80）。
英国 ICU 治疗后对邮寄问卷作出回应的患者中，超过一半报告有明显的焦虑、抑郁或 PTSD 症状。当一种心理障碍的症状存在时，有 65%的可能性会同时出现其他两种障碍之一的症状。重症疾病后抑郁与 ICU 出院后 2 年内的死亡率增加有关。
ISRCTN 注册处，ISRCTN69112866。于 2006 年 5 月 2 日注册。
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