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2019年冠状病毒病重症患者重症监护后综合征的一年结局:一项单机构研究

One-Year Outcomes of Postintensive Care Syndrome in Critically Ill Coronavirus Disease 2019 Patients: A Single Institutional Study.

作者信息

Banno Aya, Hifumi Toru, Takahashi Yuta, Soh Mitsuhito, Sakaguchi Ayako, Shimano Shodai, Miyahara Yoshie, Isokawa Shutaro, Ishii Kenji, Aoki Kazuhiro, Otani Norio, Ishimatsu Shinichi

机构信息

Department of Anesthesia and Intensive Care, St. Luke's International Hospital, Tokyo, Japan.

Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.

出版信息

Crit Care Explor. 2021 Dec 2;3(12):e0595. doi: 10.1097/CCE.0000000000000595. eCollection 2021 Dec.

Abstract

IMPORTANCE

Postintensive care syndrome has a strong impact on coronavirus disease 2019 survivors.

OBJECTIVES

Assess the 1-year prevalence of postintensive care syndrome after coronavirus disease 2019.

DESIGN SETTING AND PARTICIPANTS

This was a single-center prospective cohort using questionnaires and telephone calls from 4 months to 1 year after ICU discharge. Patients who were treated for coronavirus disease 2019-related acute respiratory distress between March 19, 2020, and April 30, 2020, participated.

MAIN OUTCOMES AND MEASURES

Postintensive care syndrome was evaluated according to physical, mental, and cognitive domains. We surveyed the 8-item standardized Short Form questionnaire for assessing physical postintensive care syndrome; the Impact of Event Scale-Revised and the Hospital Anxiety and Depression Scale for assessing mental postintensive care syndrome; and Short-Memory Questionnaire for assessing cognitive postintensive care syndrome. The primary outcome was postintensive care syndrome occurrence of any domain at 1 year. Furthermore, the co-occurrence of the three postintensive care syndrome domains was assessed.

RESULTS

Eighteen patients consented to the study and completed the survey. The median age was 57.5 years, and 78% of the patients were male. Median Acute Physiology and Chronic Health Evaluation-II score was 18. During ICU stay, 78% received invasive mechanical ventilation, and 83% received systemic steroid administration. Early mobilization was implemented in 61%. Delirium occurred in 44%. The median days of ICU and hospital stay were 6 and 23.5, respectively. Overall postintensive care syndrome occurrence was 67%. Physical, mental, and cognitive postintensive care syndrome occurred in 56%, 50%, and 33% of patients, respectively. The co-occurrence of all three domains of postintensive care syndrome was 28%. Age and Acute Physiology and Chronic Health Evaluation-II scores were higher, and systemic steroids were more commonly used in the postintensive care syndrome groups compared with the nonpostintensive care syndrome groups. Chronic symptoms were more common in the postintensive care syndrome groups than the nonpostintensive care syndrome groups.

CONCLUSIONS AND RELEVANCE

Patients who suffered critical illness from coronavirus disease 2019 had a high frequency of postintensive care syndrome after 1 year. Long-term follow-up and care should be continuously offered.

摘要

重要性

重症监护后综合征对2019冠状病毒病幸存者有重大影响。

目的

评估2019冠状病毒病后重症监护后综合征的1年患病率。

设计、地点和参与者:这是一项单中心前瞻性队列研究,在重症监护病房出院后4个月至1年使用问卷调查和电话随访。纳入了2020年3月19日至2020年4月30日期间因2019冠状病毒病相关急性呼吸窘迫接受治疗的患者。

主要结局和测量指标

根据身体、心理和认知领域评估重症监护后综合征。我们使用8项标准化简短问卷评估身体重症监护后综合征;使用事件影响量表修订版和医院焦虑抑郁量表评估心理重症监护后综合征;使用简短记忆问卷评估认知重症监护后综合征。主要结局是1年时任何领域出现重症监护后综合征。此外,还评估了重症监护后综合征三个领域的共现情况。

结果

18名患者同意参与研究并完成了调查。中位年龄为57.5岁,78%的患者为男性。急性生理与慢性健康状况评分系统II的中位评分为18分。在重症监护病房住院期间,78%的患者接受了有创机械通气,83%的患者接受了全身类固醇治疗。61%的患者实施了早期活动。44%的患者发生了谵妄。重症监护病房和住院的中位天数分别为6天和23.5天。总体重症监护后综合征发生率为67%。身体、心理和认知重症监护后综合征的发生率分别为56%、50%和33%。重症监护后综合征所有三个领域的共现率为28%。与非重症监护后综合征组相比,重症监护后综合征组患者的年龄和急性生理与慢性健康状况评分系统II评分更高,全身类固醇的使用更为普遍。慢性症状在重症监护后综合征组比非重症监护后综合征组更常见。

结论与意义

2019冠状病毒病重症患者1年后重症监护后综合征的发生率较高。应持续提供长期随访和护理。

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