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Frequency of Follow-Up Assessment for Post-Intensive Care Syndrome Among Alert and Non-Delirious Critically Ill Patients

Introduction: Many patients surviving critical illness develop post-intensive care syndrome, a constellation of psychological, physical, and cognitive symptoms which can have long-term consequences. Physicians and nurses at our large rural teaching hospital treat many of the critically ill patients...

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Autores principales: Hadler, Rachel A, Dexter, Franklin, Gu, Brian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9800000/
https://www.ncbi.nlm.nih.gov/pubmed/36600854
http://dx.doi.org/10.7759/cureus.32027
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author Hadler, Rachel A
Dexter, Franklin
Gu, Brian
author_facet Hadler, Rachel A
Dexter, Franklin
Gu, Brian
author_sort Hadler, Rachel A
collection PubMed
description Introduction: Many patients surviving critical illness develop post-intensive care syndrome, a constellation of psychological, physical, and cognitive symptoms which can have long-term consequences. Physicians and nurses at our large rural teaching hospital treat many of the critically ill patients in the state. Our focus has been the subset of these critically ill patients who were alert and not delirious for multiple consecutive days. The goal of our retrospective cohort study was to estimate the percentage of the patients with multiple intensive care unit days alert and not delirious who had follow-up assessments for post-intensive care syndrome within 15 months. Methods: The inclusion criteria for the case series of randomly selected patients were: adults defined as patients aged >17 years on the date of hospital admission between October 2014 and December 2020, present in a critical care unit at noon one day and continually so for another 48 hours, and for that interval, ≥≥48 hours had every Riker sedation-agitation scale “4, calm and cooperative,” as well as either all Confusion Assessment Method for the Intensive Care Unit scores negative (i.e., no delirium) or Delirium Observation Screening Scale <3 (i.e., no delirium). Each patient was then categorized as having a full one-year follow-up if there was an encounter at our hospital between 12 and 15 months after the last date meeting study inclusion criteria. All follow-up appointments completed within 15 months of the index intensive care unit stay were screened for systematic assessment for psychological and cognitive sequelae of critical illness. Results: From a manual chart review of 366 records, 73 patients were found with follow-up ≥≥12 months. There were 21% (15/73) of the patients assessed for post-intensive care syndrome sequelae (99% confidence interval 10%-35%). Conclusions: The fact that far fewer than half the patients had documented assessments suggests that retrospective studies should not be used to judge the incidence of post-intensive care syndrome at our hospital. Prospective observational studies would be needed to judge outcomes among critically ill patients with multiple consecutive days of alert and without delirium.
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spelling pubmed-98000002023-01-03 Frequency of Follow-Up Assessment for Post-Intensive Care Syndrome Among Alert and Non-Delirious Critically Ill Patients Hadler, Rachel A Dexter, Franklin Gu, Brian Cureus Anesthesiology Introduction: Many patients surviving critical illness develop post-intensive care syndrome, a constellation of psychological, physical, and cognitive symptoms which can have long-term consequences. Physicians and nurses at our large rural teaching hospital treat many of the critically ill patients in the state. Our focus has been the subset of these critically ill patients who were alert and not delirious for multiple consecutive days. The goal of our retrospective cohort study was to estimate the percentage of the patients with multiple intensive care unit days alert and not delirious who had follow-up assessments for post-intensive care syndrome within 15 months. Methods: The inclusion criteria for the case series of randomly selected patients were: adults defined as patients aged >17 years on the date of hospital admission between October 2014 and December 2020, present in a critical care unit at noon one day and continually so for another 48 hours, and for that interval, ≥≥48 hours had every Riker sedation-agitation scale “4, calm and cooperative,” as well as either all Confusion Assessment Method for the Intensive Care Unit scores negative (i.e., no delirium) or Delirium Observation Screening Scale <3 (i.e., no delirium). Each patient was then categorized as having a full one-year follow-up if there was an encounter at our hospital between 12 and 15 months after the last date meeting study inclusion criteria. All follow-up appointments completed within 15 months of the index intensive care unit stay were screened for systematic assessment for psychological and cognitive sequelae of critical illness. Results: From a manual chart review of 366 records, 73 patients were found with follow-up ≥≥12 months. There were 21% (15/73) of the patients assessed for post-intensive care syndrome sequelae (99% confidence interval 10%-35%). Conclusions: The fact that far fewer than half the patients had documented assessments suggests that retrospective studies should not be used to judge the incidence of post-intensive care syndrome at our hospital. Prospective observational studies would be needed to judge outcomes among critically ill patients with multiple consecutive days of alert and without delirium. Cureus 2022-11-29 /pmc/articles/PMC9800000/ /pubmed/36600854 http://dx.doi.org/10.7759/cureus.32027 Text en Copyright © 2022, Hadler et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Anesthesiology
Hadler, Rachel A
Dexter, Franklin
Gu, Brian
Frequency of Follow-Up Assessment for Post-Intensive Care Syndrome Among Alert and Non-Delirious Critically Ill Patients
title Frequency of Follow-Up Assessment for Post-Intensive Care Syndrome Among Alert and Non-Delirious Critically Ill Patients
title_full Frequency of Follow-Up Assessment for Post-Intensive Care Syndrome Among Alert and Non-Delirious Critically Ill Patients
title_fullStr Frequency of Follow-Up Assessment for Post-Intensive Care Syndrome Among Alert and Non-Delirious Critically Ill Patients
title_full_unstemmed Frequency of Follow-Up Assessment for Post-Intensive Care Syndrome Among Alert and Non-Delirious Critically Ill Patients
title_short Frequency of Follow-Up Assessment for Post-Intensive Care Syndrome Among Alert and Non-Delirious Critically Ill Patients
title_sort frequency of follow-up assessment for post-intensive care syndrome among alert and non-delirious critically ill patients
topic Anesthesiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9800000/
https://www.ncbi.nlm.nih.gov/pubmed/36600854
http://dx.doi.org/10.7759/cureus.32027
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