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重症监护病房后的生活质量:对感染和未感染新冠病毒患者的1年随访

Quality of life after ICU: 1-year follow-up in patients with and without COVID.

作者信息

Rauseo M, Ferrara G, Cotoia A, Cardinale F, Padalino S, Latronico N, Mirabella L, Cinnella G

机构信息

Anesthesia and Intensive Care Unit, Department of Medical Surgical Science, University Hospital of Foggia, Viale Pinto 1, Foggia, Italy.

Oncological Molecular Biology-Clinic Hereditary Familial Tumors, University Hospital of Foggia, Viale Pinto 1, Foggia, Italy.

出版信息

J Anesth Analg Crit Care. 2025 Jul 1;5(1):36. doi: 10.1186/s44158-025-00253-y.

Abstract

BACKGROUND

The purpose of this study was to perform a 1-year follow-up after ICU discharge and evaluate post-intensive care syndrome (PICS) in both COVID (GroupCov) and NON COVID (GroupNCov) patients.

METHODS

All consecutive patients discharged from our Intensive Care Unit (ICU) from June to December 2022 were prospectively screened. Scheduled in-person visits were carried on 3, 6, and 12 months after ICU discharge to evaluate physical, cognitive, and mental health status using different scale evaluations (SF-36, Barthel Index, ISI score, PCL-5 score, MNA-sf score, Fatigue Severity Score, MoCA Test, HADS and GDS) by means of standardized questionnaires.

RESULTS

Eighty patients (50 GroupCov vs 30 GroupNCov) were initially included, but some patients did not attend all follow-up visits. At 1-year follow-up, 60 patients (30 COVID-19 and 30 non-COVID) completed all evaluations. Both groups showed PICS, but GroupCov had a better nutritional status, better outcomes in physical evaluations, and a better perception of Quality of Life (QoL) and mental health status, but a worse cognitive assessment in the MoCA Test. Moreover, heterogeneity analysis showed that GroupNCov patients had the same trend during follow-up, while in GroupCov different trends were observed over time, especially a worse nutritional state, often found in older patients, that was related to a longer hospital stay and worse psychophysical outcomes.

CONCLUSIONS

This study shows that PICS in SARS-COV2 patients is not always homogeneous, and that different clusters of psychophysical patterns may develop over time. Although our study was only observational, it seems from our preliminary results that performing a follow-up could be the basis for a secondary prevention and to develop new therapeutic strategies after patients discharge from ICU.

摘要

背景

本研究的目的是对重症监护病房(ICU)出院后的患者进行为期1年的随访,并评估新冠患者(新冠组)和非新冠患者(非新冠组)的重症监护后综合征(PICS)。

方法

对2022年6月至12月从我们的重症监护病房出院的所有连续患者进行前瞻性筛查。在ICU出院后的3个月、6个月和12个月进行预定的面对面访视,通过标准化问卷使用不同的量表评估(SF-36、Barthel指数、ISI评分、PCL-5评分、MNA-sf评分、疲劳严重程度评分、MoCA测试、HADS和GDS)来评估身体、认知和心理健康状况。

结果

最初纳入了80例患者(50例新冠组 vs 30例非新冠组),但一些患者未参加所有随访。在1年随访时,60例患者(30例新冠患者和30例非新冠患者)完成了所有评估。两组均出现了PICS,但新冠组营养状况更好,身体评估结果更好,对生活质量(QoL)和心理健康状况的感知更好,但在MoCA测试中的认知评估更差。此外,异质性分析表明,非新冠组患者在随访期间有相同趋势,而新冠组随时间观察到不同趋势,尤其是营养状况较差,这在老年患者中经常出现,与住院时间较长和心理生理结果较差有关。

结论

本研究表明,SARS-CoV-2患者的PICS并不总是相同的,并且随着时间的推移可能会出现不同的心理生理模式集群。虽然我们的研究只是观察性的,但从我们的初步结果来看,进行随访似乎可以作为二级预防的基础,并在患者从ICU出院后制定新的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec09/12211204/d6742b2c966f/44158_2025_253_Fig1_HTML.jpg

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