Hospices Civils de Lyon, Hôpital Edouard Herriot, Service des Urgences Psychiatriques, Lyon, France.
Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Psychiatrie de l'adulte, Lyon, France.
Crit Care Med. 2020 Nov;48(11):1572-1579. doi: 10.1097/CCM.0000000000004551.
To evaluate the diagnostic accuracy of the Impact Event Scale-Revisited assessed following ICU discharge to predict the emergence of post-traumatic stress disorder symptoms at 3 months.
Prospective cohort study.
Three medical or surgical ICU of a French university hospital (Lyon, France).
Patients greater than or equal to 18 years old, leaving ICU after greater than or equal to 2 nights of stay, between September 2017 and April 2018.
Patients completed the Impact Event Scale-Revisited and the Peritraumatic Dissociative Experiences Questionnaire within 8 days after ICU discharge and the Impact Event Scale-Revisited again at 3 months by phone. Patients having an Impact Event Scale-Revisited greater than or equal to 35 at 3 months were considered as having post-traumatic stress disorder symptoms.
Among the 208 patients screened, 174 were included and 145 reassessed by phone at 3 months. Among the patients included at baseline, 43% presented symptoms of acute stress. At 3 months, 13% had an Impact Event Scale-Revisited greater than or equal to 35 and 17% had a score between 12 and 34. Regarding the performance of the Impact Event Scale-Revisited performed within 8 days after the ICU discharge to predict post-traumatic stress disorder symptoms at 3 months, the area under the curve was 0.90 (95% CI, 0.80-0.99), and an Impact Event Scale-Revisited greater than or equal to 12 had a sensitivity of 90%, a specificity of 71%, a positive predictive value of 32%, and a negative predictive value of 98%. History of anxiety disorder odds ratio = 3.7 (95% CI, 1.24-11.05; p = 0.02) and Impact Event Scale-Revisited greater than or equal to 12 odds ratio = 16.57 (95% CI, 3.59-76.46; p < 0.001) were identified as risk factors for post-traumatic stress disorder symptoms.
Impact Event Scale-Revisited assessed at ICU discharge has a good ability for the detection of patients at risk of developing post-traumatic stress disorder symptoms. Patients with history of anxiety disorder and those presenting acute stress symptoms at ICU discharge are more at risk to develop post-traumatic stress disorder symptoms.
评估 ICU 出院后评估的影响事件量表修订版（Impact Event Scale-Revisited）预测 3 个月时创伤后应激障碍症状出现的诊断准确性。
前瞻性队列研究。
法国一所大学医院的三个内科或外科 ICU（法国里昂）。
年龄大于等于 18 岁，在 ICU 入住大于等于 2 晚后离开，时间为 2017 年 9 月至 2018 年 4 月。
患者在 ICU 出院后 8 天内完成影响事件量表修订版和创伤时分离体验问卷，并在 3 个月时通过电话再次完成影响事件量表修订版。在 3 个月时，影响事件量表修订版评分大于等于 35 的患者被认为患有创伤后应激障碍症状。
在 208 名被筛查的患者中，174 名患者被纳入研究，其中 145 名患者在 3 个月时通过电话进行了重新评估。在基线时纳入的患者中，43%存在急性应激症状。在 3 个月时，13%的患者影响事件量表修订版评分大于等于 35，17%的患者评分在 12 到 34 之间。关于 ICU 出院后 8 天内进行的影响事件量表修订版对 3 个月时创伤后应激障碍症状的预测性能，曲线下面积为 0.90（95%CI，0.80-0.99），影响事件量表修订版评分大于等于 12 时的灵敏度为 90%，特异性为 71%，阳性预测值为 32%，阴性预测值为 98%。焦虑障碍病史的比值比=3.7（95%CI，1.24-11.05；p=0.02）和影响事件量表修订版评分大于等于 12 的比值比=16.57（95%CI，3.59-76.46；p<0.001）被确定为创伤后应激障碍症状的危险因素。
ICU 出院时评估的影响事件量表修订版对检测有发生创伤后应激障碍症状风险的患者具有良好的能力。有焦虑障碍病史和 ICU 出院时存在急性应激症状的患者更有可能发生创伤后应激障碍症状。
