The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors-a prospective cohort study.
The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors-a prospective cohort study.
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DOI：
10.1186/s40560-017-0272-6
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发表时间：
2018
影响因子：
7.1
通讯作者：
Sackey P
中科院分区：
文献类型：
--
作者：
Brück E;Schandl A;Bottai M;Sackey P
许多重症监护病房(ICU)幸存者会出现心理问题和认知障碍。脓毒症、精神错乱和后来的认知问题之间的关系还没有完全阐明，心理症状对ICU幸存者认知功能的影响也没有得到很好的研究。这项研究的主要目的是检查脓毒症、ICU精神错乱和后来的自我评估认知功能之间的关系。第二个目的是调查心理问题与入住ICU 3个月后自我评估的认知功能之间的关系。在瑞典斯德哥尔摩卡罗林斯卡大学索尔纳医院的综合ICU停留超过24小时的患者在ICU逗留期间使用困惑评估方法(CAM-ICU)进行了精神错乱的筛查。记录脓毒症的发生率和严重程度。三个月后，216名患者通过邮寄方式接受了认知失败问卷(CFQ)、医院焦虑和抑郁量表(HADS)和创伤后应激症状-10(PTSS-10)问卷。125名患者(60%)回答了所有问卷。在受访者中，严重败血症或感染性休克的发生率为42%。精神错乱的总发生率为34%。合并严重败血症/感染性休克的患者出现妄想的几率较高，其优势比(OR)为3.7(95%可信区间(CI)为1.7~8.1)。58%的患者在ICU后3个月发现自我评估的认知问题。我们没有发现败血症或精神错乱与晚期自评认知功能之间的任何联系。然而，心理症状与自测认知功能之间存在相关性，其中PTSS-10评分与CFQ评分的相关性最强(r = 为0.53；p <； 为0.001)。重症监护室妄想在严重败血症/感染性休克患者中更为常见。在我们的队列中，在入住ICU 3个月后，无论是严重的脓毒症还是ICU精神错乱都与自我评估的认知功能无关。持续的心理症状，特别是创伤后应激，与自我评估的认知功能较差有关。在评估ICU幸存者的认知功能时，需要考虑心理症状。
Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU survivors. The primary aim of this study was to examine the relationship between sepsis, ICU delirium, and later self-rated cognitive function. A second aim was to investigate the association between psychological problems and self-rated cognitive function 3 months after the ICU stay. Patients staying more than 24 h at the general ICU at the Karolinska University Hospital Solna, Stockholm, Sweden, were screened for delirium with the Confusion Assessment Method-ICU (CAM-ICU) during their ICU stay. Sepsis incidence and severity were recorded. Three months later, 216 patients received the Cognitive Failures Questionnaire (CFQ), Hospital Anxiety and Depression Scale (HADS), and Post-Traumatic Stress Symptoms-10 (PTSS-10) questionnaires via postal mail. One hundred twenty-five patients (60%) responded to all questionnaires. Among respondents, the incidence of severe sepsis or septic shock was 42%. The overall incidence of delirium was 34%. Patients with severe sepsis/septic shock had a higher incidence of delirium, with an odds ratio (OR) of 3.7 (95% confidence interval (CI), 1.7–8.1). Self-rated cognitive problems 3 months post-ICU were found in 58% of the patients. We did not find any association between sepsis or delirium and late self-rated cognitive function. However, there was a correlation between psychological symptoms and self-rated cognitive function, with the strongest correlation between PTSS-10 scores and CFQ scores (r = 0.53; p < 0.001). ICU delirium is more common in severely septic/septic shock patients. In our cohort, neither severe sepsis nor ICU delirium was associated with self-rated cognitive function 3 months after the ICU stay. Ongoing psychological symptoms, particularly post-traumatic stress was associated with worse self-rated cognitive function. Psychological symptoms need to be taken into account when assessing cognitive function in ICU survivors.
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DOI：
10.1056/nejmoa1301372
发表时间：
2013-10-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
Pandharipande PP;Girard TD;Jackson JC;Morandi A;Thompson JL;Pun BT;Brummel NE;Hughes CG;Vasilevskis EE;Shintani AK;Moons KG;Geevarghese SK;Canonico A;Hopkins RO;Bernard GR;Dittus RS;Ely EW;BRAIN-ICU Study Investigators
通讯作者：
BRAIN-ICU Study Investigators
del妄作为重症疾病幸存者长期认知障碍的预测指标。
影响因子：
8.8
作者：
Girard TD;Jackson JC;Pandharipande PP;Pun BT;Thompson JL;Shintani AK;Gordon SM;Canonico AE;Dittus RS;Bernard GR;Ely EW
通讯作者：
Ely EW
影响因子：
5.7
作者：
Chavan, Sangeeta S.;Huerta, Patricio T.;Diamond, Betty
通讯作者：
Diamond, Betty
DOI：
10.1176/appi.neuropsych.23.1.16
发表时间：
2011-12-01
影响因子：
2.9
作者：
Qureshi, Salah U.;Long, Mary E.;Kunik, Mark E.
通讯作者：
Kunik, Mark E.
影响因子：
8.8
作者：
Ely, EW;Margolin, R;Inouye, SK
通讯作者：
Inouye, SK