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北非重症监护病房幸存者的创伤后应激障碍、焦虑和抑郁:一项前瞻性观察研究。

Post-traumatic stress disorder, anxiety, and depression in North African intensive care unit survivors: a prospective observational study.

作者信息

Saida Imen Ben, Zghidi Marwa, Fathallah Safa, Boussarsar Mohamed

机构信息

Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.

Medical Intensive Care Unit, Research Laboratory LR12SP09 "Heart Failure", Farhat Hached University Hospital, Sousse, Tunisia.

出版信息

Acute Crit Care. 2025 Aug;40(3):402-412. doi: 10.4266/acc.000150. Epub 2025 Aug 29.

Abstract

BACKGROUND

Survivors of critical illness often face significant physical and psychological challenges, including post-traumatic stress disorder (PTSD), anxiety, and depression, which can severely impact their quality of life. This study aimed to evaluate the prevalence and associated factors of PTSD, anxiety, and depression among intensive care unit (ICU) survivors 3 months after discharge, and investigate the prevalence and determinants of post-intensive care syndrome-related neuropsychiatric disorders (PICS-ND).

METHODS

This is a prospective observational analytical study carried out in a medical ICU. Three months after discharge from the ICU, survivors were contacted by telephone to complete the Impact Event Scale-Revised and Hospital Anxiety and Depression Scale questionnaires. Univariate and multivariate analyses were performed to identify variables that were independently and significantly associated with outcomes.

RESULTS

A total of 114 survivors was enrolled. At 3 months, PTSD, anxiety, and depression were prevalent in 21.9%, 21.0%, and 9.6% of patients, respectively. Associated factors were younger age, female, physical restraint, and critical illness polyneuropathy and myopathy (CIPNM) for PTSD; unmarried, low Charlson index, and physical restraint for anxiety; and younger age and CIPNM for depression. PICS-ND, a composite measure of neuropsychiatric morbidity, was present in 28.9% of patients, with younger age, female, and physical restraint identified as associated factors.

CONCLUSIONS

PTSD, anxiety, depression, and PICS-ND were common among ICU survivors at 3 months. Various factors, including younger age, female, unmarried, lower Charlson index, physical restraint, and CIPNM, were associated with these psychological outcomes.

摘要

背景

危重症幸存者常常面临重大的身体和心理挑战,包括创伤后应激障碍(PTSD)、焦虑和抑郁,这些会严重影响他们的生活质量。本研究旨在评估重症监护病房(ICU)幸存者出院3个月后PTSD、焦虑和抑郁的患病率及相关因素,并调查重症监护后综合征相关神经精神障碍(PICS-ND)的患病率及决定因素。

方法

这是一项在医疗ICU中进行的前瞻性观察性分析研究。在ICU出院3个月后,通过电话联系幸存者,让他们完成修订后的冲击事件量表和医院焦虑抑郁量表问卷。进行单因素和多因素分析以确定与结果独立且显著相关的变量。

结果

共纳入114名幸存者。在3个月时,PTSD、焦虑和抑郁的患病率分别为21.9%、21.0%和9.6%。PTSD的相关因素为年龄较小、女性、身体约束以及危重症性多发性神经病和肌病(CIPNM);焦虑的相关因素为未婚、低查尔森指数和身体约束;抑郁 的相关因素为年龄较小和CIPNM。PICS-ND是一种神经精神疾病的综合测量指标,在28.9%的患者中存在,年龄较小、女性和身体约束被确定为相关因素。

结论

PTSD、焦虑、抑郁和PICS-ND在ICU幸存者3个月时很常见。包括年龄较小、女性、未婚、较低的查尔森指数、身体约束和CIPNM在内的各种因素与这些心理结果相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ce7/12408482/3abcc6f58717/acc-000150f1.jpg

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