Ayenew Temesgen, Gete Menberu, Gedfew Mihretie, Getie Addisu, Afenigus Abebe Dilie, Edmealem Afework, Amha Haile, Alem Girma, Tiruneh Bekele Getenet, Messelu Mengistu Abebe
Department of Nursing, Debre Markos University, College of Health Sciences.
Department of Internal Medicine, Debre Markos University, School of Medicine.
PLoS One. 2025 May 8;20(5):e0323311. doi: 10.1371/journal.pone.0323311. eCollection 2025.
Post-intensive Care Syndrome (PICS) is defined as various physical, psychological, and cognitive, impairments that can arise during an ICU stay, continue after leaving the ICU, or even persist following hospital discharge. It impacts both patients and their family's quality of life. Various primary studies worldwide have reported prevalence of PICS among ICU survivors. However, these studies exhibit inconsistency and wide variations. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of post intensive care syndrome among intensive care unit survivors along with its association with ICU length of stay.
We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist for this review. We searched PubMed/Medline, CINHAL, Embase, and Google scholar to retrieve articles. The Newcastle Ottawa Scale (NOS) was used for quality assessment of articles. The random effects model with I-squared test was used to estimate the prevalence of PICS and its association with ICU length of stay. To identify the source of heterogeneity within the included studies, meta-regression and subgroup analysis were used. We employed Egger's regression test and funnel plots for assessing publication bias. STATA version 17.0 software was used for all statistical analyses. A p-value of < 0.05 with 95% confidence interval was used declare statistically significant.
A total of 19 articles with a population of 10179 ICU-survivors were included in this review. The pooled prevalence of PICS was found to be 54.35% (95% CI = 45.54, 63.15). In sub-group analysis by region, the highest prevalence was observed in studies done in south and north America with overall prevalence of 61.95% (95% CI = 28.33, 95.62). Among the three domains of PICS (physical, cognitive and mental domains), the highest prevalence score was observed in the physical domain with overall prevalence of 45.99% (95% CI = 34.66, 57.31). In this meta-analysis, those patients who stayed more than four days in the ICU were 1.207 [95% CI = 1.119, 1.295] times more likely to develop at least one among the three domains of PICS in the post-intensive care period than their counterparts.
This systematic review and meta-analysis demonstrate a high prevalence of PICS among ICU survivors, and highlight the significant association between ICU length of stay and the development of PICS. These findings underscore the need for targeted interventions to mitigate the long-term effects of critical illness, particularly for patients with prolonged ICU stays.
重症监护后综合征（PICS）被定义为在重症监护病房（ICU）住院期间可能出现、离开ICU后仍持续存在甚至出院后仍会持续的各种身体、心理和认知障碍。它会影响患者及其家人的生活质量。全球各地的各种初步研究报告了ICU幸存者中PICS的患病率。然而，这些研究结果存在不一致性且差异很大。因此，本系统评价和荟萃分析旨在估计ICU幸存者中重症监护后综合征的合并患病率及其与ICU住院时间的关联。
我们使用系统评价和荟萃分析的首选报告项目（PRISMA）2020清单进行本综述。我们检索了PubMed/Medline、CINHAL、Embase和谷歌学术以检索文章。使用纽卡斯尔渥太华量表（NOS）对文章进行质量评估。采用带有I²检验的随机效应模型来估计PICS的患病率及其与ICU住院时间的关联。为了确定纳入研究中异质性的来源，我们使用了荟萃回归和亚组分析。我们采用Egger回归检验和漏斗图来评估发表偏倚。所有统计分析均使用STATA 17.0软件。p值<0.05且95%置信区间被用于判定具有统计学意义。
本综述共纳入了19篇文章，涉及10179名ICU幸存者。发现PICS的合并患病率为54.35%（95%置信区间=45.54，63.15）。在按地区进行的亚组分析中，在南美洲和北美洲进行的研究中观察到最高患病率，总体患病率为61.95%（95%置信区间=28.33，95.62）。在PICS的三个领域（身体、认知和心理领域）中，身体领域的患病率得分最高，总体患病率为45.99%（95%置信区间=34.66，57.31）。在这项荟萃分析中，在ICU住院超过四天的患者在重症监护后期出现PICS三个领域中至少一个领域问题的可能性是其同行的1.207倍[95%置信区间=1.119，1.295]。
本系统评价和荟萃分析表明ICU幸存者中PICS的患病率很高，并突出了ICU住院时间与PICS发生之间的显著关联。这些发现强调了需要有针对性的干预措施来减轻危重病的长期影响，特别是对于ICU住院时间延长的患者。
