Ramnarain Dharmanand, Den Oudsten Brenda, Oldenbeuving Annemarie, Pouwels Sjaak, De Vries Jolanda
Department of Intensive Care Medicine, Elisabeth-TweeSteden Ziekenhuis (ETZ), Tilburg, NLD.
Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disease (CoRPS), Tilburg University, Tilburg, NLD.
Cureus. 2023 Mar 27;15(3):e36739. doi: 10.7759/cureus.36739. eCollection 2023 Mar.
Introduction Survivors of an acute subarachnoid hemorrhage (aSAH) may suffer from a long-term neurological disability, cognitive impairment, anxiety, and depression, which can also be related to post-intensive care syndrome (PICS). The aim of this study was to examine the prevalence of PICS symptoms in post-intensive care (ICU) aftercare aSAH patients. Methods We conducted an observational cohort study in aSAH patients from a post-ICU aftercare clinic (ICU-AC). PICS symptoms were evaluated using the Impact of Event Scale-Revised (IES-R), Hospital Anxiety and Depression Scale (HADS), and a medical questionnaire for physical and cognitive functioning. Results A total of 110 patients were included. The prevalence of anxiety and depressive symptoms was 23.6% and 19.1%, respectively. Post-traumatic stress disorder (PTSD) was seen in 26.4%. Cognitive complaints were lack of concentration (63.6%), short-term memory loss (45.8%), and reduced speed of thinking (60.9%). The most reported physical complaints were fatigue (73.6%), limitations in daily activity (72.7%), muscle weakness (41.8%), pain (36.4%), and weight loss (30.9%). PICS symptoms related to all three domains were present in 30% of patients. Conclusion The prevalence of PICS in patients after aSAH is high. Even in patients without aSAH-related neurological impairment who were discharged home, a high prevalence of PICS symptoms was reported. Early screening for PICS should comprise all three domains and is important to facilitate a better tailored rehabilitation of these patients.
引言 急性蛛网膜下腔出血(aSAH)幸存者可能会长期遭受神经功能残疾、认知障碍、焦虑和抑郁,这些也可能与重症监护后综合征(PICS)有关。本研究的目的是调查aSAH患者重症监护(ICU)后续护理中PICS症状的患病率。方法 我们对一家ICU后续护理诊所(ICU-AC)的aSAH患者进行了一项观察性队列研究。使用事件影响量表修订版(IES-R)、医院焦虑抑郁量表(HADS)以及一份关于身体和认知功能的医学问卷对PICS症状进行评估。结果 共纳入110例患者。焦虑和抑郁症状的患病率分别为23.6%和19.1%。创伤后应激障碍(PTSD)的患病率为26.4%。认知方面的主诉有注意力不集中(63.6%)、短期记忆力减退(45.8%)和思维速度减慢(60.9%)。最常报告的身体主诉有疲劳(73.6%)、日常活动受限(72.7%)、肌肉无力(41.8%)、疼痛(36.4%)和体重减轻(30.9%)。30%的患者存在与所有三个领域相关的PICS症状。结论 aSAH患者中PICS的患病率很高。即使是没有aSAH相关神经功能障碍且已出院回家的患者,PICS症状的患病率也很高。PICS的早期筛查应涵盖所有三个领域,这对于促进这些患者更有针对性的康复很重要。