重症监护幸存者3个月纵向随访期间重症监护后综合征患病率及危险因素分析

IF 3 3区 医学 Q1 NURSING
Shuang Gao, Xifeng Liang, Yaning Lyu, Xiuping Zhang, Liwen Zhang
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引用次数: 0

摘要

背景:重症监护病房(ICU)出院的患者可能会经历重症监护后综合征(PICS),这是由认知、身体和心理障碍组成的。目的:本研究的目的是确定ICU出院后第1个月和第3个月PICS的患病率和相关的危险因素。设计:对中国某大学附属医院的两个icu进行前瞻性描述性分析研究。我们使用中文版的《健康老年脑保健监测自我报告》,量表从1到57,其中57表示最差结果,综合评估患者离开ICU后第1个月和第3个月随访时的PICS。我们采用逐步多元线性回归分析探讨危险因素与PICS之间的关系。结果:在第一个月和第三个月的随访中,我们分别招募了654名和584名参与者。超过60%的患者经历了不同程度的PICS,最严重的损害是在身体领域。我们对与PICS相关的危险因素进行分类,分为患者相关、疾病相关和icu相关因素。在这些危险因素中,只有作为家庭的主要收入来源,消化系统疾病的诊断、创伤和ICU出院时有创导管的数量对两次随访的PICS都有显著的预测作用。icu相关的危险因素应给予更多的关注,因为它们有可能被改变。结论:该人群在ICU住院后出现PICS的发生率和严重程度均较高。ICU护士和医护人员应共同协作,加强对综合危险因素的关注,实施有针对性的预防措施。与临床实践的相关性:ICU工作人员必须对PICS有全面的认识,全面了解其危险因素,以便在入院时主动评估PICS高危患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence of and risk factors analysis for post-intensive care syndrome among survivors of critical care during 3-month longitudinal follow-up.

Background: Patients discharged from the intensive care unit (ICU) can experience post-intensive care syndrome (PICS), which is comprised of cognitive, physical and psychological impairments.

Aim: The objective of this study was to identify the prevalence of and risk factors associated with all three domains of PICS at the first and third month after ICU discharge.

Design: A prospective descriptive-analytic study was conducted in two ICUs of a Chinese university hospital. We used the Healthy Aging Brain Care Monitor Self-Report Chinese version, a scale from 1 to 57, with 57 indicating the worst outcome, to comprehensively assess PICS at the first and third month follow-ups after patients left the ICU. We performed an analysis of stepwise multiple linear regression to explore the relationship between risk factors and PICS.

Results: We enrolled 654 and 584 participants at the first- and third-month follow-ups, respectively. More than 60% of patients experienced different degrees of PICS, with the most severe impairment being in the physical domain. We classified risk factors associated with PICS, categorized as patient-related, disease-related, and ICU-related factors. Among these risk factors, only being the main income provider for the family, the diagnosis of digestive system disease, trauma and the number of invasive catheters at ICU discharge significantly predicted PICS at both follow-ups. ICU-related risk factors should be given greater attention, given their potential for modification.

Conclusions: The prevalence and severity of PICS were high in this population after their ICU stay. ICU nurses and medical staff members should collaborate to pay more attention to the comprehensive risk factors and implement targeted preventive measures.

Relevance to clinical practice: ICU staff must have a holistic view of PICS and a comprehensive understanding of its risk factors to proactively evaluate patients at high risk of PICS upon admission to the hospital.

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来源期刊
CiteScore
6.00
自引率
13.30%
发文量
109
审稿时长
>12 weeks
期刊介绍: Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics. Papers published in the journal normally fall into one of the following categories: -research reports -literature reviews -developments in practice, education or management -reflections on practice
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