患者和家属的重症监护后综合征。对 COVID-19 和非 COVID-19 组群进行分析,并在三个月和一年后进行面对面随访。

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引用次数: 0

摘要

目的:比较两个队列(COVID 和非 COVID)中重症监护后患者(P-PICS)和家属/护理人员(F-PICS)综合征的发病率和概况,并分析风险因素:比较两个队列(COVID 和非 COVID)中重症监护后患者(P-PICS)和家属/护理人员(F-PICS)综合征的患病率和概况,并分析 P-PICS 的风险因素:前瞻性观察队列(2018年3月-2023年),随访三个月和一年:14张病床的多价重症监护病房(ICU),二级医院.患者或参与者:265名患者和209名亲属.患者纳入标准:年龄大于 18 岁、机械通气时间大于 48 小时、在重症监护室住院时间大于 5 天、谵妄、脓毒性休克、急性呼吸窘迫综合征、心脏骤停。纳入标准家属:参与干预的家属:干预措施:出院后 3 个月和 1 年的随访:患者:社会人口学、临床、演变、身体、心理和认知改变、依赖程度和生活质量。主要护理人员:精神状态和身体超负荷:64.9%的 PICS-P,组间无差异。COVID 患者比非 COVID 患者有更多的身体改变(P = .028)。这些患者的功能退化更严重(P = .005),生活质量更差(P = .003),营养状况变化更大(P = .004),认知能力更差(P < .001)。19.1% 的 PICS-F,在非 COVID 患者的亲属中更为常见(17.6% 对 5.5%;P = .013)。PICS-P的独立预测因素:研究的第一年(OR:0.484)、较高的合并症(OR:1.158)、谵妄(OR:2.935)、纳入的几个原因(OR:3.171)和咪达唑仑(OR:4.265):结论:两组患者的 PICS-P 和 PICS-F 发生率相似。与出现 SPCI-P 相关的主要因素有:合并症较多、谵妄、咪达唑仑、入院原因不止一个以及入院最初几年。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Postintensive care syndrome in patients and family members. Analysis of COVID-19 and non-COVID-19 cohorts, with face-to-face follow-up at three months and one year

Objective

Compare prevalence and profile of post-intensive care patient (P-PICS) and family/caregiver (F-PICS) syndrome in two cohorts (COVID and non-COVID) and analyse risk factors for P-PICS.

Design

Prospective, observational cohort (March 2018–2023), follow-up at three months and one year.

Setting

14-bed polyvalent Intensive Care Unit (ICU), Level II Hospital.

Patients or participants

265 patients and 209 relatives. Inclusion criteria patients: age > 18 years, mechanical ventilation > 48 h, ICU stay > 5 days, delirium, septic shock, acute respiratory distress syndrome, cardiac arrest. Inclusion criteria family: those who attended.

Interventions

Follow-up 3 months and 1 year after hospital discharge.

Main variables of interest

Patients: sociodemographic, clinical, evolutive, physical, psychological and cognitive alterations, dependency degree and quality of life. Main caregivers: mental state and physical overload.

Results

64.9% PICS-P, no differences between groups. COVID patients more physical alterations than non-COVID (P = .028). These more functional deterioration (P = .005), poorer quality of life (P = .003), higher nutritional alterations (P = .004) and cognitive deterioration (P < .001). 19.1% PICS-F, more frequent in relatives of non-COVID patients (17.6% vs. 5.5%; P = .013). Independent predictors of PICS-P: first years of the study (OR: 0.484), higher comorbidity (OR: 1.158), delirium (OR: 2.935), several reasons for being included (OR: 3.171) and midazolam (OR: 4.265).

Conclusions

Prevalence PICS-P and PICS-F between both cohorts was similar. Main factors associated with the development of SPCI-P were: higher comorbidity, delirium, midazolan, inclusion for more than one reason and during the first years.

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