Incidence and influencing factors of post-intensive care cognitive impairment |
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| Institution: | 1. Department of Nursing, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550001, China;2. School of Nursing, Lanzhou University, Lanzhou, Gansu Province 730000, China;3. Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, Gansu Province 730000, China;4. Department of Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu Province 730000, China;5. Department of Nursing, Henan Provincial People’s Hospital, Peoples’ Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450003, China;6. School of Public Health, Lanzhou University, Lanzhou, Gansu Province 730000, China;1. Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK;2. Oxford University Hospital NHS Foundation Trust, UK;3. NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK;1. Department of Pharmacy, AdventHealth Orlando, 601 East Rollins Street, Orlando, FL 32803, USA;2. Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA;3. Department of Nursing, AdventHealth Orlando, 601 East Rollins Street, Orlando, FL 32803, USA;4. Department of Surgery, AdventHealth Orlando, 601 East Rollins Street, Orlando, FL 32803, USA;5. Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA;1. NHMRC Centre for Research Excellence in Nursing, Griffith University, Nathan Campus, Brisbane, Queensland, Australia;2. Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia;3. School of Nursing and Midwifery, Griffith University, Nathan Campus, Brisbane, Queensland, Australia;4. Princess Alexandra Hospital Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia;5. School of Applied Psychology, Griffith University, Mt. Gravatt Campus, Brisbane, Queensland, Australia;6. School of Medicine, Griffith University, Logan Campus, Meadowbrook, Queensland, Australia;7. Centre for Applied Health Economics, Griffith University, Logan Campus, Meadowbrook, Queensland, Australia;8. School of Health Sciences, City University London, London, UK;1. National Center for Infection Prevention, Swissnoso, Bern, Switzerland;2. Infectious Diseases & Hospital Hygiene, Thurgau Hospital Group, Muensterlingen and Frauenfeld, Switzerland;3. Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, WHO Collaborating Center for Patient Safety, Geneva, Switzerland;4. Department of Infectious Disease Epidemiology, Imperial College London, London, UK;2. Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan;1. Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065, Australia;2. Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia |
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| Abstract: | ObjectiveTo evaluate the incidence and risks factors of short-term post-intensive care (ICU) cognitive impairment.DesignProspective, observational study.SettingClosed university-affiliated intensive care unit.PatientsWe enrolled consecutive patients >18 yrs of age expected to be in intensive care unit for ≥24 hours.InterventionsNone.Measurements and main resultsThe score of Montreal Cognitive Assessment (MoCA) less than 26 was defined as cognitive impairment at hospital discharge and short-term post-ICU cognitive impairment was diagnosed in 185 of 409 assessed patients (45.2%). According to univariate analysis, age, years of education, occupation, past medical history, main ICU diagnosis, Acute Physiology and Chronic Evaluation Scoring System (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, Charlson comorbidity index, ICU length-of-stay (LOS), total hospital LOS, sedation, vasoactive agents, muscle relaxants, mechanical ventilation and duration of mechanical ventilation, constraints, early active mobilisation, hypoxemia, frequency and severity of delirium, blood pressure, rescue experience, and infection were significant predictors of post-ICU cognitive impairment. Multivariate analysis results showed that the frequency and severity of delirium, and advanced age were risk factors of post-ICU cognitive impairment; high years of education and early active mobilisation were protective factors.ConclusionsIncidence of post-ICU cognitive impairment is at a high level, which is similar to former researches’ results; the frequency and severity of delirium, and advanced age were risk factors of post-ICU cognitive impairment; high years of education and early active mobilisation were protective factors of post-ICU cognitive impairment. |
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| Keywords: | Critical illness Cognitive impairment Post-intensive care syndrome Incidence Influencing factors |
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