Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, P.O Box 1078 Blindern, NO-0316 Oslo, Norway.
Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, P.O Box 1078 Blindern, NO-0316 Oslo, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.
Intensive Crit Care Nurs. 2024 Oct;84:103761. doi: 10.1016/j.iccn.2024.103761. Epub 2024 Jul 16.
Intensive care unit (ICU) patients experience several symptoms, yet patterns of symptoms and their relationship with demographic and clinical characteristics have not previously been investigated.
To identify and compare subgroups (i.e. latent symptom classes) of intensive ICU patients based on prevalence of co-occurring symptoms over seven days.
Prospective cohort study of adult ICU patients' self-reports of five symptoms during seven days in ICU. Latent class analysis was applied to identify subgroups of ICU patients.
Multicenter study with patients from six mixed ICUs in Norway.
Patient Symptom Survey was used to assess five symptoms (i.e., thirst, pain, anxiousness, tiredness, shortness of breath).
Among 353 included patients, median age was 63 years and 60.3 % were male. Subgroups of patients were identified in a Low class (n = 126, 35.7 %), Middle Class (n = 177, 50.1 %) and High Class (n = 50, 14.2 %) based on reporting of the prevalence of five symptoms. Patients in the Low class had a low prevalence of all symptoms. Middle Class patients had a high prevalence of thirst and tiredness and a low prevalence of pain, anxiousness and shortness of breath. The High class patients had a high prevalence of all symptoms. Symptom prevalence remained stable in the Low and Middle class over time and increased over time in the High class. There were significant differences among symptom classes in use of mechanical ventilation (p = 0.012), analgesics (p < 0.001), alpha-2 agonists (p = 0.004) and fluid restriction (p = 0.006). Patients in the High class received more of these ICU-treatments.
Findings suggest that subgroups of ICU patients with distinct symptom experiences can be identified. The High prevalence class patients had consistently high levels of all symptoms across seven ICU days and received more ICU-related interventions.
Some ICU patients experience a consistently high prevalence of co-occurring symptoms. Clinicians should be aware of treatment factors that could be linked to a high burden of symptoms.
重症监护病房（ICU）患者会出现多种症状，但症状模式及其与人口统计学和临床特征的关系尚未得到研究。
根据七天内同时出现的症状，确定并比较 ICU 患者的亚组（即潜在的症状类别）。
前瞻性队列研究，纳入 ICU 成年患者在 ICU 七天内自我报告的五种症状。应用潜在类别分析确定 ICU 患者的亚组。
来自挪威六个混合 ICU 的多中心研究。
采用患者症状调查评估五种症状（即口渴、疼痛、焦虑、疲倦、呼吸急促）。
纳入 353 例患者，中位年龄 63 岁，60.3%为男性。根据五种症状的报告发生率，确定了低发生率（n=126，35.7%）、中发生率（n=177，50.1%）和高发生率（n=50，14.2%）三组患者。低发生率组所有症状的发生率均较低。中发生率组患者口渴和疲倦的发生率较高，疼痛、焦虑和呼吸急促的发生率较低。高发生率组患者所有症状的发生率均较高。低发生率和中发生率组症状的发生率随时间稳定，高发生率组随时间增加。三组患者机械通气（p=0.012）、镇痛（p<0.001）、α-2 激动剂（p=0.004）和液体限制（p=0.006）的使用存在显著差异。高发生率组患者接受了更多的 ICU 治疗。
研究结果表明，可确定具有不同症状体验的 ICU 患者亚组。高发生率组患者在七天 ICU 期间始终存在所有症状的高发生率，并接受了更多的 ICU 相关干预措施。
一些 ICU 患者会持续出现多种症状。临床医生应注意可能与症状负担增加相关的治疗因素。
