Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden.
Section of Anaesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Sci Rep. 2024 Jul 9;14(1):15863. doi: 10.1038/s41598-024-66028-7.
Modern intensive care has improved survival rates, but emerging evidence suggests a high prevalence of post-intensive care unit (ICU) health problems, including post-traumatic stress disorder, depression and anxiety. These symptoms may have a detrimental effect on quality of life and increase mortality. The primary objective of this study is to examine the extent of initiation of antidepressant medication among ICU survivors and identify the factors associated with its usage. The secondary objective is to investigate whether the use of these medications is linked to an increased mortality. The nationwide study cohort included 125,130 ICU survivors admitted between 2010 and 2017. Within the first 3 months after ICU discharge, 7% of patients initiated antidepressant medication, by 1 year 15.5% had started medication. We found no tendency to a decrease during the 2-year follow-up period. Factors associated with antidepressant use included middle age, female sex, psychiatric and somatic comorbid conditions, substance dependence, higher illness severity, and longer ICU stay. Antidepressant users had a higher mortality rate, and deaths due to external causes and suicide were more frequent in this group. This study emphasizes the importance of detecting and addressing depression in ICU survivors to improve their quality of life and reduce mortality rates.
现代重症监护已经提高了存活率，但新出现的证据表明，重症监护病房（ICU）后存在大量健康问题，包括创伤后应激障碍、抑郁和焦虑。这些症状可能对生活质量产生不利影响，并增加死亡率。本研究的主要目的是检查 ICU 幸存者开始使用抗抑郁药物的程度，并确定与其使用相关的因素。次要目的是研究这些药物的使用是否与死亡率增加有关。这项全国性研究队列包括 2010 年至 2017 年间收治的 125130 名 ICU 幸存者。在 ICU 出院后的头 3 个月内，有 7%的患者开始使用抗抑郁药物，1 年后有 15.5%的患者开始使用。在 2 年的随访期间，我们没有发现使用量减少的趋势。与使用抗抑郁药物相关的因素包括中年、女性、精神和躯体合并症、物质依赖、更高的疾病严重程度和更长的 ICU 住院时间。使用抗抑郁药物的患者死亡率更高，该组的死亡原因更多为外部原因和自杀。这项研究强调了在 ICU 幸存者中检测和治疗抑郁的重要性，以提高他们的生活质量并降低死亡率。
