Cognitive Impairment, Physical Impairment, and Psychological Symptoms in Intensive Care Unit Survivors

Author:

Proffitt Tracye1,Menzies Victoria2,Grap Mary Jo3,Orr Tamara4,Thacker Leroy5,Ameringer Suzanne6

Affiliation:

1. Tracye Proffitt is an assistant professor at Virginia Commonwealth University School of Nursing, Richmond, Virginia.

2. Victoria Menzies is an associate professor at University of Florida College of Nursing, Gainesville, Florida.

3. Mary Jo Grap is a professor emeritus at Virginia Commonwealth University School of Nursing.

4. Tamara Orr is a clinical health psychologist at Virginia Commonwealth University School of Medicine, Richmond.

5. Leroy Thacker II is an associate professor, Department of Biostatistics, Virginia Commonwealth University School of Medicine.

6. Suzanne Ameringer is a professor and associate dean for academic affairs at Virginia Commonwealth University School of Nursing.

Abstract

Background Post–intensive care syndrome (PICS) affects 25% to 50% of adults who survive an intensive care unit (ICU) stay. Although the compounding of PICS impairments (cognitive, physical, and psychological) could intensify the syndrome, research on relationships among impairments is limited, particularly in patients with delirium. Objectives To examine associations among PICS impairments and examine delirium status and its relationship to PICS impairments at ICU discharge and 1 month later. Methods A descriptive, correlational study of adults who survived an ICU stay. Participants completed measures for depression, anxiety, posttraumatic stress, physical function, functional status, and cognition at ICU discharge and 1 month later. Relationships among PICS impairments were examined with Spearman correlations; differences in impairments by delirium status were assessed with t tests. Results Of 50 enrolled participants, 46 were screened for PICS impairment at ICU discharge and 35 were screened 1 month later. Cognitive impairment was the most common impairment at both time points. A positive correlation was found between cognition and functional status at ICU discharge (ρ = 0.50, P = .001) and 1 month later (ρ = 0.54, P = .001). Cognition and physical functioning were positively correlated 1 month after discharge (ρ = 0.46, P = .006). The group with delirium had significantly lower functional status scores than the group without delirium at ICU discharge (P = .04). Conclusions The findings suggest a moderate correlation between cognitive and physical impairments. This relationship should be explored further; ICU survivors with undiagnosed cognitive impairment may have delayed physical recovery and greater risk for injury.

Publisher

AACN Publishing

Subject

Critical Care Nursing,General Medicine

Reference79 articles.

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3. Barrett ML, Smith MW, Elixhauser A, Honigman LS, Pines JM. Utilization of intensive care services, 2011. Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project statistical brief #185. December 2014. Accessed March 30, 2022. https://hcup-us.ahrq.gov/reports/statbriefs/sb185-Hospital-Intensive-Care-Units-2011.jsp

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5. Co-occurrence of post-intensive care syndrome problems among 406 survivors of critical illness;Marra;Crit Care Med,2018

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