Post-ICU psychological morbidity in very long ICU stay patients with ARDS and delirium

    loading  Checking for direct PDF access through Ovid

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.

Related Topics

    loading  Loading Related Articles