Rai Sumeet, Neeman Teresa, Brown Rhonda, Sundararajan Krishnaswamy, Rajamani Arvind, Miu Michelle, Panwar Rakshit, Nourse Mary, van Haren Frank M P, Mitchell Imogen, Needham Dale M
School of Medicine and Psychology, Australian National University, Canberra, Australia.
Intensive Care Unit, Canberra Hospital, Canberra, Australia.
Crit Care Resusc. 2023 Dec 13;26(1):8-15. doi: 10.1016/j.ccrj.2023.10.011. eCollection 2024 Mar.
OBJECTIVE: To compare long-term psychological symptoms and health-related quality of life (HRQOL) in intubated versus non-intubated ICU survivors. DESIGN: Prospective, multicentre observational cohort study. SETTING: Four tertiary medical-surgical ICUs in Australia. PARTICIPANTS: Intubated and non-intubated adult ICU survivors. MAIN OUTCOME MEASURES: : clinically significant psychological symptoms at 3- and 12-month follow-up using Post-Traumatic Stress Syndrome-14 for post-traumatic stress disorder; Depression, Anxiety Stress Scales-21 for depression, anxiety, and stress. : HRQOL, using EuroQol-5D-5L questionnaire. RESULTS: Of the 133 ICU survivors, 54/116 (47 %) had at least one clinically significant psychological symptom (i.e., post-traumatic stress disorder, anxiety, depression, stress) at follow-up. Clinically significant scores for psychological symptoms were observed in 26 (39 %) versus 16 (32 %) at 3-months [odds ratio 1.4, 95 % confidence interval (0.66-3.13), p = 0.38]; 23 (37 %) versus 10 (31 %) at 12-months [odds ratio 1.3, 95 % confidence interval (0.53-3.31), p = 0.57] of intubated versus non-intubated survivors, respectively. Usual activities and mobility were the most commonly affected HRQOL dimension, with >30 % at 3 versus months and >20 % at 12-months of overall survivors reporting ≥ moderate problems. There was no difference between the groups in any of the EQ5D dimensions. CONCLUSIONS: Nearly one-in-two (47 %) of the intubated and non-intubated ICU survivors reported clinically significant psychological symptoms at 3 and 12-month follow-ups. Overall, more than 30 % at 3-months and over 20 % at 12-months of the survivors in both groups had moderate or worse problems with their usual activities and mobility. The presence of psychological symptoms and HRQOL impairments was similar between the groups.
目的:比较插管与未插管的重症监护病房(ICU)幸存者的长期心理症状及健康相关生活质量(HRQOL)。 设计:前瞻性、多中心观察性队列研究。 地点:澳大利亚的四家三级医疗外科重症监护病房。 参与者:插管和未插管的成年ICU幸存者。 主要观察指标:在3个月和12个月随访时,使用创伤后应激综合征-14量表评估创伤后应激障碍的临床显著心理症状;使用抑郁、焦虑、压力量表-21评估抑郁、焦虑和压力。使用欧洲五维健康量表-5D-5L问卷评估HRQOL。 结果:在133名ICU幸存者中,54/116(47%)在随访时有至少一种临床显著心理症状(即创伤后应激障碍、焦虑、抑郁、压力)。在3个月时,插管幸存者中有26人(39%)出现临床显著心理症状评分,未插管幸存者中有16人(32%)出现该评分[比值比1.4,95%置信区间(0.66 - 3.13),p = 0.38];在12个月时,插管幸存者中有23人(37%),未插管幸存者中有10人(31%)出现该评分[比值比1.3,95%置信区间(0.53 - 3.31),p = 0.57]。日常活动和行动能力是HRQOL中最常受影响的维度,在3个月时超过30%的总体幸存者以及在12个月时超过20%的总体幸存者报告有中度或更严重的问题。两组在欧洲五维健康量表的任何维度上均无差异。 结论:近二分之一(47%)的插管和未插管ICU幸存者在3个月和12个月随访时报告有临床显著心理症状。总体而言,两组中超过30%的幸存者在3个月时以及超过20%的幸存者在12个月时在日常活动和行动能力方面存在中度或更严重的问题。两组中心理症状和HRQOL损害的情况相似。
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