Shima Nozomu, Miyamoto Kyohei, Shibata Mami, Nakashima Tsuyoshi, Kaneko Masahiro, Shibata Naoaki, Shima Yukihiro, Kato Seiya
Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama City Japan.
Department of Thoracic and Cardiovascular Surgery Wakayama Medical University Wakayama City Japan.
Acute Med Surg. 2020 Sep 1;7(1):e557. doi: 10.1002/ams2.557. eCollection 2020 Jan-Dec.
In post-intensive care syndrome (PICS), long-term survivors of critical illness present various physical and mental symptoms that can persist for years after discharge. Post-intensive care syndrome in Japan has not been well described, so this study aims to elucidate its epidemiology.
We undertook a single-center prospective longitudinal cohort study in a mixed intensive care unit (ICU) in a Japanese tertiary hospital. Adult patients emergently admitted to the ICU were eligible for inclusion in the study. To assess activity of daily living (ADL) status and psychiatric symptoms, we posted a questionnaire at 3 and 12 months after discharge from the ICU. We evaluated ADL status, anxiety, depression, and post-traumatic stress disorder symptoms using the Barthel index, Hospital Anxiety and Depression Scale, and Impact of Event Scale - Revised, respectively.
Enrolled in this study were 204 patients. We received responses from 117/147 (80%) and 74/98 (76%) patients at 3 and 12 months, respectively. At 3 months, the prevalence of ADL disability, anxiety, depression, and post-traumatic stress disorder symptoms was 32%, 42%, 48%, and 20%, respectively. At 12 months, the prevalence was 22%, 33%, 39%, and 21%, respectively. The prevalence of any symptoms was 66% at 3 months and 55% at 12 months. Barthel index score at 12 months was improved significantly from that at 3 months. Hospital Anxiety and Depression Scale and Impact of Event Scale - Revised scores at 12 months showed no improvement.
At 3 and 12 months after ICU discharge, over half of our Japanese patients suffered ADL disability and/or psychiatric symptoms. The ADL disability improved at 1 year, but psychiatric symptoms did not.
在重症监护后综合征（PICS）中，危重病长期幸存者会出现各种身体和精神症状，这些症状在出院后可能持续数年。日本的重症监护后综合征尚未得到充分描述，因此本研究旨在阐明其流行病学情况。
我们在日本一家三级医院的综合性重症监护病房（ICU）进行了一项单中心前瞻性纵向队列研究。急诊入住ICU的成年患者符合纳入本研究的条件。为了评估日常生活活动（ADL）状态和精神症状，我们在患者从ICU出院后的3个月和12个月发放了问卷。我们分别使用Barthel指数、医院焦虑抑郁量表和事件影响量表修订版来评估ADL状态、焦虑、抑郁和创伤后应激障碍症状。
本研究共纳入204例患者。我们分别收到了117/147（80%）和74/98（76%）例患者在3个月和12个月时的回复。在3个月时，ADL残疾、焦虑、抑郁和创伤后应激障碍症状的患病率分别为32%、42%、48%和20%。在12个月时，患病率分别为22%、33%、39%和21%。任何症状的患病率在3个月时为66%，在12个月时为55%。12个月时的Barthel指数评分较3个月时显著改善。12个月时的医院焦虑抑郁量表和事件影响量表修订版评分没有改善。
在ICU出院后的3个月和12个月，我们的日本患者中有超过一半患有ADL残疾和/或精神症状。ADL残疾在1年后有所改善，但精神症状没有。
