Prevalence of post-intensive care syndrome among Japanese intensive care unit patients: a prospective, multicenter, observational J-PICS study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-02-16

AUTHORS

Daisuke Kawakami, Shigeki Fujitani, Takeshi Morimoto, Hisashi Dote, Mumon Takita, Akihiro Takaba, Masaaki Hino, Michitaka Nakamura, Hiromasa Irie, Tomohiro Adachi, Mami Shibata, Jun Kataoka, Akira Korenaga, Tomoya Yamashita, Tomoya Okazaki, Masatoshi Okumura, Takefumi Tsunemitsu

ABSTRACT

BackgroundMany studies have compared quality of life of post-intensive care syndrome (PICS) patients with age-matched population-based controls. Many studies on PICS used the 36-item Short Form (SF-36) health survey questionnaire version 2, but lack the data for SF-36 values before and after intensive care unit (ICU) admission. Thus, clinically important changes in the parameters of SF-36 are unknown. Therefore, we determined the frequency of co-occurrence of PICS impairments at 6 months after ICU admission. We also evaluated the changes in SF-36 subscales and interpreted the patients’ subjective significance of impairment.MethodsA prospective, multicenter, observational cohort study was conducted in 16 ICUs across 14 hospitals in Japan. Adult ICU patients expected to receive mechanical ventilation for > 48 h were enrolled, and their 6-month outcome was assessed using the questionnaires. PICS definition was based on the physical status, indicated by the change in SF-36 physical component score (PCS) ≥ 10 points; mental status, indicated by the change in SF-36 mental component score (MCS) ≥ 10 points; and cognitive function, indicated by the worsening of Short-Memory Questionnaire (SMQ) score and SMQ score at 6 months < 40. Multivariate logistic regression model was used to identify the factors associated with PICS occurrence. The patients’ subjective significance of physical and mental symptoms was assessed using the 7-scale Global Assessment Rating to evaluate minimal clinically important difference (MCID).ResultsAmong 192 patients, 48 (25%) died at 6 months. Among the survivors at 6 months, 96 patients responded to the questionnaire; ≥ 1 PICS impairment occurred in 61 (63.5%) patients, and ≥ 2 occurred in 17 (17.8%) patients. Physical, mental, and cognitive impairments occurred in 32.3%, 14.6% and 37.5% patients, respectively. Population with only mandatory education was associated with PICS occurrence (odds ratio: 4.0, 95% CI 1.1–18.8, P = 0.029). The MCID of PCS and MCS scores was 6.5 and 8.0, respectively.ConclusionsAmong the survivors who received mechanical ventilation, 64% had PICS at 6 months; co-occurrence of PICS impairments occurred in 20%. PICS was associated with population with only mandatory education. Future studies elucidating the MCID of SF-36 scores among ICU patients and standardizing the PICS definition are required.Trial registration UMIN000034072. More... »

PAGES

69

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  • Journal

    TITLE

    Critical Care

    ISSUE

    1

    VOLUME

    25

    Author Affiliations

  • Department of Anesthesia and Critical Care, Kobe City Medical Center General Hospital, 2-1-1, Minatojima minamimachi, Chuo-ku, 650-0047, Kobe-City, Hyogo Prefecture, Japan
  • Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 216-8511, Kawasaki, Kanagawa Prefecture, Japan
  • Department of Clinical Epidemiology, Hyogo College of Medicine, 663-8501, Nishinomiya, Hyogo Prefecture, Japan
  • Department of Emergency and Critical Care Medicine, Seirei Hamamatsu General Hospital, 430-8558, Hamamatsu, Shizuoka Prefecture, Japan
  • Department of Emergency and Critical Care Medicine, Hiroshima General Hospital, 738-8503, Hatsukaichi, JAHisoshima Prefecture, Japan
  • Emergency and Critical Care Center, Kurashiki Central Hospital, 710-8602, Kurashiki, Okayama Prefecture, Japan
  • Department of Critical Care Medicine, Nara Prefecture General Medical Center, 630-8581, Nara, Nara Prefecture, Japan
  • Department of Anesthesiology, Kurashiki Central Hospital, 710-8602, Kurashiki, Okayama Prefecture, Japan
  • Emergency and Critical Care Center, Tokyo Women’s Medical University Medical Center East, 116-8567, Tokyo, Japan
  • Department of Emergency and Critical Care Medicine, Wakayama Medical University, 641-8510, Wakayama, Wakayama Prefecture, Japan
  • Department of Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, 279-0001, Urayasu, Chiba, Japan
  • Department of Emergency Medicine, Japanese Red Cross Wakayama Medical Center, 640-8558, Wakayama, Wakayama Prefecture, Japan
  • Department of Emergency and Critical Care, Osaka City General Hospital, 534-0021, Osaka, Japan
  • Emergency Medical Center, Kagawa University Hospital, 761-0793, Kita, Kagawa Prefecture, Japan
  • Department of Anesthesiology, Aichi Medical University Hospital, 480-1195, Nagakute, Aichi Prefecture, Japan
  • Department of Emergency Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyogo Prefecture, 660-8550, Amagasaki, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s13054-021-03501-z

    DOI

    http://dx.doi.org/10.1186/s13054-021-03501-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1135413160

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33593406


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