Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Crit Care Med. 2020 Aug;48(8):e675-e683. doi: 10.1097/CCM.0000000000004413.
To estimate incidence of newly diagnosed mental disorders among ICU patients.
Retrospective-matched cohort study using a population-based administrative database.
Manitoba, Canada.
A total of 49,439 ICU patients admitted between 2000 and 2012 were compared with two control groups (hospitalized: n = 146,968 and general population: n = 141,937), matched on age (± 2 yr), sex, region of residence, and hospitalization year.
None.
Incident mental disorders (mood, anxiety, substance use, personality, posttraumatic stress disorder, schizophrenia, and psychotic disorders) not diagnosed during the 5-year period before the index ICU or hospital admission date (including matched general population group), but diagnosed during the subsequent 5-year period. Multivariable survival models adjusted for sociodemographic variables, Charlson comorbidity index, admission diagnostic category, and number of ICU and non-ICU exposures. ICU cohort had a 14.5% (95% CI, 14.0-15.0) and 42.7% (95% CI, 42.0-43.5) age- and sex-standardized incidence of any diagnosed mental disorder at 1 and 5 years post-ICU exposure, respectively. In multivariable analysis, ICU cohort had increased risk of any diagnosed mental disorder at all time points versus the hospitalized cohort (year 5: adjusted hazard ratio, 2.00; 95% CI, 1.80-2.23) and the general population cohort (year 5: adjusted hazard ratio, 3.52; 95% CI, 3.23-3.83). A newly diagnosed mental disorder was associated with younger age, female sex, more recent admitting years, presence of preexisting comorbidities, and repeat ICU admission.
ICU admission is associated with an increased incidence of mood, anxiety, substance use, and personality disorders over a 5-year period.
估计 ICU 患者新发精神障碍的发病率。
使用基于人群的行政数据库进行回顾性匹配队列研究。
加拿大马尼托巴省。
将 2000 年至 2012 年间入住的 49439 名 ICU 患者与两组对照组（住院患者：n=146968 人，普通人群：n=141937 人）进行比较，匹配年龄（±2 岁）、性别、居住地区和住院年份。
无。
在 ICU 入住前 5 年内未诊断出（包括匹配的普通人群组），但在随后的 5 年内诊断出的新发精神障碍（心境、焦虑、物质使用、人格、创伤后应激障碍、精神分裂症和精神病性障碍）。多变量生存模型调整了社会人口统计学变量、Charlson 合并症指数、入院诊断类别以及 ICU 和非 ICU 暴露次数。与住院患者队列（第 5 年：调整后的危险比，2.00；95%CI，1.80-2.23）和普通人群队列（第 5 年：调整后的危险比，3.52；95%CI，3.23-3.83）相比，ICU 队列在 ICU 暴露后 1 年和 5 年时任何诊断出的精神障碍的年龄和性别标准化发病率分别为 14.5%（95%CI，14.0-15.0）和 42.7%（95%CI，42.0-43.5）。在多变量分析中，ICU 队列在所有时间点均比住院患者队列（第 5 年：调整后的危险比，2.00；95%CI，1.80-2.23）和普通人群队列（第 5 年：调整后的危险比，3.52；95%CI，3.23-3.83）罹患任何诊断出的精神障碍的风险更高。新发精神障碍与年龄较小、女性、最近入院年份、存在预先存在的合并症和重复 ICU 入院有关。
ICU 入住与 5 年内心境、焦虑、物质使用和人格障碍的发病率增加相关。
