Post-Icu Psychological Morbidity in Very Long Icu Stay Patients With Ards and Delirium Publisher Pubmed



Bashar FR¹ ; Vahedianazimi A² ; Hajiesmaeili M³ ; Salesi M⁴ ; Farzanegan B⁵ ; Shojaei S³ ; Goharani R³ ; Madani SJ⁶ ; Moghaddam KG⁷ ; Hatamian S⁸ ; Moghaddam HJ⁹ ; Mosavinasab SMM² ; Elamin EM^{10, 11} ; Miller AC^{12, 13}
Source: Journal of Critical Care Published:2018

Abstract

Purpose We investigated the impact of delirium on illness severity, psychological state, and memory in acute respiratory distress syndrome patients with very long ICU stay. Materials and methods Prospective cohort study in the medical-surgical ICUs of 2 teaching hospitals. Very long ICU stay (> 75 days) and prolonged delirium (≥ 40 days) thresholds were determined by ROC analysis. Subjects were ≥ 18 years, full-code, and provided informed consent. Illness severity was assessed using Acute Physiology and Chronic Health Evaluation IV, Simplified Acute Physiology Score-3, and Sequential Organ Failure Assessment scores. Psychological impact was assessed using the Hospital Anxiety and Depression Scale, Impact of Event Scale-Revised, and the 14-question Post-Traumatic Stress Syndrome (PTSS-14). Memory was assessed using the ICU Memory Tool survey. Results 181 subjects were included. Illness severity did not correlate with delirium duration. On logistic regression, only PTSS-14 < 49 correlated with delirium (p = 0.001; 95% CI 1.011, 1.041). 49% remembered their ICU stay clearly. 47% had delusional memories, 50% reported intrusive memories, and 44% reported unexplained feelings of panic or apprehension. Conclusion Delirium was associated with memory impairment and PTSS-14 scores suggestive of PTSD, but not illness severity. © 2017