Are intensive care factors associated with depressive symptoms 6 months after acute lung injury?
Are intensive care factors associated with depressive symptoms 6 months after acute lung injury?
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DOI：
10.1097/ccm.0b013e31819fea55
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发表时间：
2009-05-01
影响因子：
8.8
通讯作者：
Needham, Dale M.
中科院分区：
文献类型：
--
作者：
Dowdy, David W.;Bienvenu, Oscar Joseph;Needham, Dale M.
目的：评估重症监护相关因素作为急性肺损伤（ALI）后6个月抑郁症状的预测因子。设计：前瞻性队列研究。设置：巴尔的摩，MD的4家医院的13个重症监护室（ICU）。患者：连续性ALI幸存者（n = 160; 71%来自医学ICU）在ALI后6个月筛查抑郁症状。干预：无。测量和主要结果：我们前瞻性地测量了危重病和ICU护理的12个特征，并使用多变量回归来评估与医院焦虑和抑郁评分测量的抑郁症状的相关性。在ALI后6个月，抑郁症筛查阳性（评分8）的患病率为26%。抑郁症状与手术治疗显著相关，（与医疗或创伤相比）ICU入院（相对风险[RR] 2.2，95%置信区间[CI] 1.1-4.2），每日最大序贯器官衰竭评估评分>10（RR 2.1，95% CI 1.1-3.5），ICU苯二氮卓类药物平均日剂量≥ 75 mg咪达唑仑当量结论：ALI后6个月的抑郁症状是常见的，可能与ICU相关因素有关。危重病和重症监护管理与抑郁症状相关的机制值得进一步研究。(Crit Care Med 2009; 37：1702-1707）
Objective: To evaluate intensive care-related factors as predictors of depressive symptoms 6 months after acute lung injury (ALI).Design: Prospective cohort study.Setting: Thirteen intensive care units (ICUs) in four hospitals in Baltimore, MD.Patients: Consecutive ALI survivors (n = 160; 71% from medical ICUs) screened for depressive symptoms at 6 months post-ALI.Interventions: None.Measurements and Main Results: We prospectively measured 12 features of critical illness and ICU care and used multivariable regression to evaluate associations with depressive symptoms as measured by the Hospital Anxiety and Depression Score. The prevalence of a positive screening for depression (score 8) at 6 months post-ALI was 26%. Depressive symptoms were significantly associated with surgical (vs. medical or trauma) ICU admission (relative risk [RR] 2.2, 95% confidence interval [CI] 1.1-4.2), maximum daily Sequential Organ Failure Assessment Score of >10 (RR 2.1, 95% CI 1.1-3.5), and mean daily ICU benzodiazepine dose of >= 75 mg of midazolam equivalent (RR 2.1, 95% CI 1.1-3.5).Conclusions: Depressive symptoms at 6 months post-ALI are common and potentially associated with ICU-related factors. Mechanisms by which critical illness and intensive care management associate with depressive symptoms merit further investigation. (Crit Care Med 2009; 37:1702-1707)