Department of Neurology, University of Leipzig Medical Center, Liebigstr. 20, 04103, Leipzig, Germany.
Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.
Sci Rep. 2020 Sep 23;10(1):15518. doi: 10.1038/s41598-020-72109-0.
In this prospective cohort study we aimed to investigate the trajectory of the cognitive performance of patients after discharge from an intensive care unit (ICU). Special consideration was given to patients with suspected premorbid cognitive impairment who might be at risk for the development of dementia. Clinical characteristics were collected until discharge. The premorbid cognitive state was estimated by a structured interview with a close relative. Cognitive outcome was assessed using the Consortium to Establish a Registry of Alzheimer's Disease (CERAD) Plus battery and the Stroop Color and Word Test at the time of discharge from ICU and 9 months later. The results of the study group were compared to an established healthy control group and to normative data. A total number of 108 patients were finally included. At the time of discharge, patients underperformed the healthy control group. In linear regression models, delirium during the ICU stay and the factor premorbid cognitive impairment were associated with poorer cognitive outcome (p = 0.047 and p = 0.001). After 9 months, in 6% of patients without evidence of premorbid cognitive impairment long-lasting deficits were found. In patients with suspected premorbid cognitive impairment, performance in tests of executive function failed to improve.
在这项前瞻性队列研究中，我们旨在调查重症监护病房（ICU）出院后患者认知表现的轨迹。特别关注那些可能有痴呆风险的疑似有潜在认知障碍的患者。临床特征一直收集到出院。潜在认知状态通过与近亲进行的结构化访谈进行评估。认知结果使用 Consortium to Establish a Registry of Alzheimer's Disease (CERAD) Plus 电池和 Stroop 颜色和单词测试在 ICU 出院时和 9 个月后进行评估。研究组的结果与既定的健康对照组和常模数据进行了比较。最终共纳入 108 例患者。在出院时，患者的表现逊于健康对照组。在线性回归模型中，ICU 期间的谵妄和潜在认知障碍因素与较差的认知结果相关（p=0.047 和 p=0.001）。9 个月后，在没有潜在认知障碍证据的患者中，有 6%的患者发现存在持久的认知缺陷。在疑似潜在认知障碍的患者中，执行功能测试的表现未能改善。
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