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Development of an ICU discharge instrument predicting psychological morbidity: a multinational study
Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden;Karolinska Univ Hosp, Dept Perioperat Med & Intens Care, Stockholm, Sweden.
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.
Univ Utrecht, Univ Med Ctr Utrecht, Dept Intens Care Med, Utrecht, Netherlands.
Soder Sjukhuset, Dept Anaesthesiol & Intens Care, Stockholm, Sweden.
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2018 (Engelska)Ingår i: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 44, nr 12, s. 2038-2047Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

PurposeTo develop an instrument for use at ICU discharge for prediction of psychological problems in ICU survivors.MethodsMultinational, prospective cohort study in ten general ICUs in secondary and tertiary care hospitals in Sweden, Denmark and the Netherlands. Adult patients with an ICU stay12h were eligible for inclusion. Patients in need of neurointensive care, with documented cognitive impairment, unable to communicate in the local language, without a home address or with more than one limitation of therapy were excluded. Primary outcome was psychological morbidity 3months after ICU discharge, defined as Hospital Anxiety and Depression Scale (HADS) subscale score11 or Post-traumatic Stress Symptoms Checklist-14 (PTSS-14) part B score>45.ResultsA total of 572 patients were included and 78% of patients alive at follow-up responded to questionnaires. Twenty percent were classified as having psychological problems post-ICU. Of 18 potential risk factors, four were included in the final prediction model after multivariable logistic regression analysis: symptoms of depression [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.10-1.50], traumatic memories (OR 1.44, 95% CI 1.13-1.82), lack of social support (OR 3.28, 95% CI 1.47-7.32) and age (age-dependent OR, peak risk at age 49-65years). The area under the receiver operating characteristics curve (AUC) for the instrument was 0.76 (95% CI 0.70-0.81).ConclusionsWe developed an instrument to predict individual patients' risk for psychological problems 3months post-ICU, http://www.imm.ki.se/biostatistics/calculators/psychmorb/. The instrument can be used for triage of patients for psychological ICU follow-up.Trial registrationThe study was registered at clinicaltrials.gov, NCT02679157.

Ort, förlag, år, upplaga, sidor
SPRINGER , 2018. Vol. 44, nr 12, s. 2038-2047
Nyckelord [en]
Intensive care, PICS, Follow-up, Depression, Post-traumatic stress, Anxiety
Nationell ämneskategori
Anestesi och intensivvård
Identifikatorer
URN: urn:nbn:se:uu:diva-372772DOI: 10.1007/s00134-018-5467-3ISI: 000452162900002PubMedID: 30467678OAI: oai:DiVA.org:uu-372772DiVA, id: diva2:1278235
Tillgänglig från: 2019-01-14 Skapad: 2019-01-14 Senast uppdaterad: 2019-01-14Bibliografiskt granskad

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