Rojas Danielle A, Sayde George E, Vega Jason S, Tincher Isabella M, Yuan Mina, Flanary Kristin, Birk Jeffrey L, Agarwal Sachin
Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA.
Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, USA.
J Clin Med. 2024 Sep 5;13(17):5266. doi: 10.3390/jcm13175266.
: Post-intensive care syndrome (PICS) affects many critical care survivors and family members. Nevertheless, the relationship between PICS-relevant domains in cardiac arrest (CA) survivors and psychological distress in their family members (henceforth, PICS-F) remains underexplored. : We enrolled consecutive CA patients admitted between 16 August 2021 and 28 June 2023 to an academic medical center, along with their close family members, in prospective studies. Survivors' PICS domains were: physical dependence (Physical Self-Maintenance Scale, PSMS), cognitive impairments (Modified Telephone Interview for Cognitive Status, TICS-M), and post-traumatic stress disorder (PTSS) symptoms (PTSD Checklist-PCL 5), as well as PICS-F (PCL-5 Total Score). Hierarchical multivariate linear regressions examined associations between PICS-F and survivors' PICS domains. : Of 74 dyads ( = 148), survivors had a mean () age of 56 ± 16 years, with 61% being male and with a median hospital stay of 28 days. Family members (43% spouses) were slightly younger (52 ± 14 years), predominantly female (72%), and of minority race/ethnicity (62%). A high prevalence of PICS assessed 28.5 days (interquartile range 10-63) post-CA was observed in survivors (78% physical dependence, 54% cognitive impairment, 30% PTSS) and in family members (30% PTSS). Survivor PTSS was significantly associated with family member distress ( = 0.3, = 0.02), independent of physical dependence ( = 0.0, = 0.9), cognitive impairment ( = -0.1, = 0.5), family member characteristics, and duration of hospitalization. : Both CA survivors and their family members showed substantial evidence of likely PICS. Survivor PTSS is notably associated with family member distress, highlighting the need for dyadic interventions to enhance psychosocial outcomes.
重症监护后综合征(PICS)影响着许多重症监护幸存者及其家庭成员。然而,心脏骤停(CA)幸存者中与PICS相关的领域与其家庭成员的心理困扰(以下简称PICS-F)之间的关系仍未得到充分研究。
我们将2021年8月16日至2023年6月28日期间入住一家学术医疗中心的连续性CA患者及其亲密家庭成员纳入前瞻性研究。幸存者的PICS领域包括:身体依赖(身体自我维持量表,PSMS)、认知障碍(改良认知状态电话访谈,TICS-M)、创伤后应激障碍(PTSS)症状(创伤后应激障碍检查表-PCL 5)以及PICS-F(PCL-5总分)。分层多元线性回归分析了PICS-F与幸存者PICS领域之间的关联。
在74对(n = 148)研究对象中,幸存者的平均(±)年龄为56±16岁,61%为男性,中位住院时间为28天。家庭成员(43%为配偶)年龄稍小(52±14岁),以女性为主(72%),且为少数种族/族裔(62%)。在CA后28.5天(四分位间距10 - 63)评估发现,幸存者(78%存在身体依赖、54%存在认知障碍、30%存在PTSS)和家庭成员(30%存在PTSS)中PICS的患病率较高。幸存者的PTSS与家庭成员的困扰显著相关(β = 0.3,P = 0.02),独立于身体依赖(β = 0.0,P = 0.9)、认知障碍(β = -0.1,P = 0.5)、家庭成员特征及住院时长。
CA幸存者及其家庭成员均显示出可能患有PICS的大量证据。幸存者的PTSS与家庭成员的困扰显著相关,这突出了采取二元干预措施以改善心理社会结局的必要性。