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脓毒症幸存者 ICU 出院后创伤后应激、焦虑和抑郁的患病率及其危险因素。

Prevalence and risk factors for post-traumatic stress, anxiety, and depression in sepsis survivors after ICU discharge.

机构信息

Escola de Medicina, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG, Brazil.

Programa de Pós-Graduação em Ciências da Saúde, Infectologia e Medicina Tropical (PPG-IMT), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

出版信息

Braz J Psychiatry. 2021 May-Jun;43(3):269-276. doi: 10.1590/1516-4446-2020-0986.

Abstract

OBJECTIVE

Sepsis survivors present a wide range of sequelae; few studies have evaluated psychiatric disorders after sepsis. The objective of this study was to define the prevalence of and risk factors for anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in sepsis survivors.

METHOD

Anxiety, depression and post-traumatic stress symptoms in severe sepsis and septic shock survivors 24 h and 1 year after intensive care unit (ICU) discharge were assessed using the Beck Anxiety/Depression Inventories and the PTSD Checklist-Civilian Version. Differences in psychiatric symptoms over time and the influence of variables on these symptoms were calculated with marginal models.

RESULTS

A total of 33 patients were enrolled in the study. The frequencies of anxiety, depression and PTSD 24 h after ICU discharge were 67%, 49%, and 46%, respectively and, among patients re-evaluated 1 year after ICU discharge, the frequencies were 38%, 50%, and 31%, respectively. Factors associated with PTSD included serum S100B level, age, and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) score. Factors associated with depression included patient age and cumulative dose of dobutamine. IQCODE score and cumulative dose of haloperidol in the ICU were associated with anxiety after ICU discharge.

CONCLUSION

Patients who survive sepsis have high levels of psychiatric symptoms. Sepsis and associated treatment-related exposures may have a role in increasing the risk of subsequent depression, anxiety, and PTSD.

摘要

目的

脓毒症幸存者存在广泛的后遗症;很少有研究评估脓毒症后的精神障碍。本研究的目的是确定脓毒症幸存者焦虑、抑郁和创伤后应激障碍(PTSD)症状的患病率和危险因素。

方法

使用贝克焦虑/抑郁量表和 PTSD 清单-平民版评估严重脓毒症和脓毒性休克幸存者在 ICU 出院后 24 小时和 1 年时的焦虑、抑郁和创伤后应激症状。使用边缘模型计算精神症状随时间的差异以及变量对这些症状的影响。

结果

共有 33 名患者入组研究。ICU 出院后 24 小时焦虑、抑郁和 PTSD 的发生率分别为 67%、49%和 46%,在 ICU 出院后 1 年重新评估的患者中,发生率分别为 38%、50%和 31%。与 PTSD 相关的因素包括血清 S100B 水平、年龄和认知衰退询问表(IQCODE)评分。与抑郁相关的因素包括患者年龄和多巴酚丁胺累积剂量。ICU 中的 IQCODE 评分和氟哌啶醇累积剂量与 ICU 后焦虑有关。

结论

存活脓毒症的患者有较高水平的精神症状。脓毒症和相关的治疗相关暴露可能在增加随后发生抑郁、焦虑和 PTSD 的风险方面发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62f6/8136386/c8cad05cbe32/bjp-43-03-269-g001.jpg

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