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Prevalence of post-intensive care syndrome among Japanese intensive care unit patients: a prospective, multicenter, observational J-PICS study

Daisuke KawakamiDepartment of Anesthesia and Critical Care, Kobe City Medical Center General Hospital, 2-1-1, Minatojima minamimachi, Chuo-ku, Kobe-City, Hyogo Prefecture, 650-0047, Japan. [email protected]Shigeki FujitaniDepartment of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa Prefecture, 216-8511, JapanTakeshi MorimotoDepartment of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo Prefecture, 663-8501, JapanHisashi DoteDepartment of Emergency and Critical Care Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka Prefecture, 430-8558, JapanMumon TakitaDepartment of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa Prefecture, 216-8511, JapanAkihiro TakabaDepartment of Emergency and Critical Care Medicine, Hiroshima General Hospital, Hatsukaichi, JAHisoshima Prefecture, 738-8503, JapanMasaaki HinoEmergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, Okayama Prefecture, 710-8602, JapanMichitaka NakamuraDepartment of Critical Care Medicine, Nara Prefecture General Medical Center, Nara, Nara Prefecture, 630-8581, JapanHiromasa IrieDepartment of Anesthesiology, Kurashiki Central Hospital, Kurashiki, Okayama Prefecture, 710-8602, JapanTomohiro AdachiEmergency and Critical Care Center, Tokyo Women's Medical University Medical Center East, Tokyo, 116-8567, JapanMami ShibataDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, 641-8510, JapanJun KataokaAkira KorenagaDepartment of Emergency Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Wakayama Prefecture, 640-8558, JapanTomoya YamashitaDepartment of Emergency and Critical Care, Osaka City General Hospital, Osaka, 534-0021, JapanTomoya OkazakiEmergency Medical Center, Kagawa University Hospital, Kita, Kagawa Prefecture, 761-0793, JapanMasatoshi OkumuraDepartment of Anesthesiology, Aichi Medical University Hospital, Nagakute, Aichi Prefecture, 480-1195, JapanTakefumi TsunemitsuDepartment of Emergency Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyogo Prefecture, Amagasaki, 660-8550, Japan

2021en

ABI

Annotatsiya

BACKGROUND: Many studies have compared quality of life of post-intensive care syndrome (PICS) patients with age-matched population-based controls. Many studies on PICS used the 36-item Short Form (SF-36) health survey questionnaire version 2, but lack the data for SF-36 values before and after intensive care unit (ICU) admission. Thus, clinically important changes in the parameters of SF-36 are unknown. Therefore, we determined the frequency of co-occurrence of PICS impairments at 6 months after ICU admission. We also evaluated the changes in SF-36 subscales and interpreted the patients' subjective significance of impairment. METHODS: A prospective, multicenter, observational cohort study was conducted in 16 ICUs across 14 hospitals in Japan. Adult ICU patients expected to receive mechanical ventilation for > 48 h were enrolled, and their 6-month outcome was assessed using the questionnaires. PICS definition was based on the physical status, indicated by the change in SF-36 physical component score (PCS) ≥ 10 points; mental status, indicated by the change in SF-36 mental component score (MCS) ≥ 10 points; and cognitive function, indicated by the worsening of Short-Memory Questionnaire (SMQ) score and SMQ score at 6 months < 40. Multivariate logistic regression model was used to identify the factors associated with PICS occurrence. The patients' subjective significance of physical and mental symptoms was assessed using the 7-scale Global Assessment Rating to evaluate minimal clinically important difference (MCID). RESULTS: Among 192 patients, 48 (25%) died at 6 months. Among the survivors at 6 months, 96 patients responded to the questionnaire; ≥ 1 PICS impairment occurred in 61 (63.5%) patients, and ≥ 2 occurred in 17 (17.8%) patients. Physical, mental, and cognitive impairments occurred in 32.3%, 14.6% and 37.5% patients, respectively. Population with only mandatory education was associated with PICS occurrence (odds ratio: 4.0, 95% CI 1.1-18.8, P = 0.029). The MCID of PCS and MCS scores was 6.5 and 8.0, respectively. CONCLUSIONS: Among the survivors who received mechanical ventilation, 64% had PICS at 6 months; co-occurrence of PICS impairments occurred in 20%. PICS was associated with population with only mandatory education. Future studies elucidating the MCID of SF-36 scores among ICU patients and standardizing the PICS definition are required. Trial registration UMIN000034072.

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DOI: 10.1186/s13054-021-03501-z

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