論文

2021年3月10日

Post-intensive care syndrome as a predictor of mortality in patients with critical illness: A cohort study

PLOS ONE
  • Naoya Yanagi
  • Kentaro Kamiya
  • Nobuaki Hamazaki
  • Ryota Matsuzawa
  • Kohei Nozaki
  • Takafumi Ichikawa
  • Thomas S. Valley
  • Takeshi Nakamura
  • Masashi Yamashita
  • Emi Maekawa
  • Tomotaka Koike
  • Minako Yamaoka-Tojo
  • Masayasu Arai
  • Atsuhiko Matsunaga
  • Junya Ako
  • 全て表示

16
3
開始ページ
e0244564
終了ページ
e0244564
記述言語
掲載種別
研究論文(学術雑誌)
DOI
10.1371/journal.pone.0244564
出版者・発行元
Public Library of Science (PLoS)

<sec id="sec001">
<title>Introduction</title>
The post-intensive care syndrome (PICS) encompasses multiple, diverse conditions, such as physical disability, cognitive impairment, and depression. We sought to evaluate whether conditions within PICS have similar associations with mortality among survivors of critical illness.


</sec>
<sec id="sec002">
<title>Materials and methods</title>
In this retrospective cohort study, we identified 248 critically ill patients with intensive care unit stay ≥72 hours, who underwent PICS evaluation. Patients with disability in activities of daily living, cognitive impairment, or depression before hospitalization were excluded. We defined PICS using established measures of physical disability (usual gait speed), cognitive impairment (Mini-Cog test), and depression (Patient Health Questionnaire-2) at hospital discharge. The endpoint was all-cause mortality.


</sec>
<sec id="sec003">
<title>Results</title>
Patients had a median age of 69 years and Acute Physiology and Chronic Health Evaluation (APACHE) II score of 16. One hundred thirty-two patients were classified as having PICS, and 19 patients died. 81/248 (34%) patients had physical disability, 42/248 (19%) had cognitive impairment, and 44/248 (23%) had depression. After adjusting for covariates on multivariable Cox regression analyses, PICS was significantly associated with all-cause mortality (hazard ratio [HR] 3.78, 95% confidence interval [CI] 1.02 – 13.95; <italic>P</italic> = 0.046). However, the association between PICS and all-cause mortality was related to physical disability and cognitive impairment (<italic>P</italic> = 0.001 and <italic>P</italic> = 0.027, respectively), while depression was not (<italic>P</italic> = 0.623).


</sec>
<sec id="sec004">
<title>Conclusion</title>
While PICS as a syndrome has been useful in gaining attention to the sequelae of critical illness, its relationship with long-term mortality is driven largely by physical disability and cognitive impairment and not depression.


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リンク情報
DOI
https://doi.org/10.1371/journal.pone.0244564
URL
https://dx.plos.org/10.1371/journal.pone.0244564
ID情報
  • DOI : 10.1371/journal.pone.0244564
  • eISSN : 1932-6203

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