Gao Shuang, Liang Xifeng, Lyu Yaning, Zhang Xiuping, Zhang Liwen
School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.
School of Nursing, Shandong Second Medical University, Weifang, China.
Nurs Crit Care. 2025 Sep;30(5):e13242. doi: 10.1111/nicc.13242. Epub 2025 Jan 14.
Patients discharged from the intensive care unit (ICU) can experience post-intensive care syndrome (PICS), which is comprised of cognitive, physical and psychological impairments.
The objective of this study was to identify the prevalence of and risk factors associated with all three domains of PICS at the first and third month after ICU discharge.
A prospective descriptive-analytic study was conducted in two ICUs of a Chinese university hospital. We used the Healthy Aging Brain Care Monitor Self-Report Chinese version, a scale from 1 to 57, with 57 indicating the worst outcome, to comprehensively assess PICS at the first and third month follow-ups after patients left the ICU. We performed an analysis of stepwise multiple linear regression to explore the relationship between risk factors and PICS.
We enrolled 654 and 584 participants at the first- and third-month follow-ups, respectively. More than 60% of patients experienced different degrees of PICS, with the most severe impairment being in the physical domain. We classified risk factors associated with PICS, categorized as patient-related, disease-related, and ICU-related factors. Among these risk factors, only being the main income provider for the family, the diagnosis of digestive system disease, trauma and the number of invasive catheters at ICU discharge significantly predicted PICS at both follow-ups. ICU-related risk factors should be given greater attention, given their potential for modification.
The prevalence and severity of PICS were high in this population after their ICU stay. ICU nurses and medical staff members should collaborate to pay more attention to the comprehensive risk factors and implement targeted preventive measures.
ICU staff must have a holistic view of PICS and a comprehensive understanding of its risk factors to proactively evaluate patients at high risk of PICS upon admission to the hospital.
从重症监护病房（ICU）出院的患者可能会经历重症监护后综合征（PICS），该综合征包括认知、身体和心理障碍。
本研究的目的是确定ICU出院后第一个月和第三个月时PICS所有三个领域的患病率及相关危险因素。
在中国一所大学医院的两个ICU进行了一项前瞻性描述性分析研究。我们使用中文版《健康老龄化大脑护理监测自评量表》，该量表从1到57分，57分表示最差结果，在患者离开ICU后的第一个月和第三个月随访时全面评估PICS。我们进行了逐步多元线性回归分析，以探讨危险因素与PICS之间的关系。
我们在第一个月和第三个月的随访中分别纳入了654名和584名参与者。超过60%的患者经历了不同程度的PICS，其中身体领域的损伤最为严重。我们将与PICS相关的危险因素分为患者相关、疾病相关和ICU相关因素。在这些危险因素中，只有作为家庭主要收入提供者、消化系统疾病诊断、创伤以及ICU出院时的侵入性导管数量在两次随访中均显著预测了PICS。鉴于ICU相关危险因素具有可改变的可能性，应给予更多关注。
该人群在ICU住院后PICS的患病率和严重程度较高。ICU护士和医务人员应合作，更加关注综合危险因素并实施有针对性的预防措施。
ICU工作人员必须对PICS有整体认识，并全面了解其危险因素，以便在患者入院时主动评估PICS高危患者。
