MARRA, ANNACHIARA (2017) Cooccurrence of Problems in the PostIntensive Care Syndrome among 406 Survivors of Critical Illness. [Tesi di dottorato]

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Tipologia del documento:	Tesi di dottorato
Lingua:	English
Titolo:	Cooccurrence of Problems in the PostIntensive Care Syndrome among 406 Survivors of Critical Illness
Autori:	Autore Email MARRA, ANNACHIARA dottmarraannachiara@gmail.com
Data:	27 Novembre 2017
Numero di pagine:	43
Istituzione:	Università degli Studi di Napoli Federico II
Dipartimento:	dep17
Dottorato:	phd069
Ciclo di dottorato:	30
Coordinatore del Corso di dottorato:	nome email Montagnani, Stefania montagna@unina.it
Tutor:	nome email Triassi, Maria [non definito]
Data:	27 Novembre 2017
Numero di pagine:	43
Parole chiave:	Critical Illness, Cognitive Dysfunction, Activities of Daily Living, Depression, Survivors
Settori scientifico-disciplinari del MIUR:	Area 06 - Scienze mediche > MED/41 - Anestesiologia Area 06 - Scienze mediche > MED/42 - Igiene generale e applicat
Depositato il:	19 Dic 2017 06:46
Ultima modifica:	12 Apr 2019 09:15
URI:	http://www.fedoa.unina.it/id/eprint/12015

Abstract

Purpose Post-Intensive Care Syndrome (PICS) is characterized by new or worse cognitive impairment, disability, and mental health impairment after critical illness. The frequency of co-occurring problems in PICS, along with factors associated with being PICS-free, is unclear. Methods We included patients with respiratory failure or shock, excluding those with preexisting cognitive impairment or disability in activities of daily living. At 3 and 12 months after hospital discharge, we assessed patients for cognitive impairment, disabilities in activities of daily living, and depression. We categorized patients into eight groups reflecting combinations of cognitive, disability, and mental health problems. We modeled the association between age, education, frailty, durations of mechanical ventilation, delirium, and severe sepsis with the odds of being PICS-free using multivariable regression. Results We analyzed 406 patients who were a median age of 61 years old with an APACHE II of 23. PICS was present in 64% and 56% of patients at 3 and 12 months, respectively. Co-occurring problems in all 3 domains were present in 6% at 3 months and 4% at 12 months. More years of education was associated with greater odds of being PICS-free (P<0.001 at 3 and 12 months). Frailty was associated with lower odds of being PICS-free at 3 months (P=0.005). Conclusions PICS was present in the majority of survivors of critical illness. Co-occurring problems in all 3 PICS domains was rare. Greater years of education were protective from PICS. Future studies are needed to understand better the heterogeneous subtypes of PICS and to identify modifiable risk factors for this syndrome.

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