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Original article
Available online 13 May 2024
Postintensive care syndrome in patients and family members. Analysis of COVID-19 and non-COVID-19 cohorts, with face-to-face follow-up at three months and one year
Síndrome postcuidados intensivos en pacientes y familiares. Análisis de cohortes COVID-19 y no COVID-19, con seguimiento presencial a los tres meses y al año
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Carola Giménez-Esparza Vicha,b,
Corresponding author
, Beatriz Oliver Hurtadoa,b, Maria Angeles Relucio Martineza,b, Salomé Sanchez Pinoa,b, Cristina Portillo Requenaa,b, José David Simón Simóna,b, Isabel María Pérez Gómeza,b, Fernando Mario Andrade Rodadoa,b, Fadoua Laghzaoui Harboulia,b, Fernando Javier Sotos Solanoa,b, Carlos Augusto Montenegro Mourea,b, Andrés Carrillo Alcaraza,b
a Hospital Vega Baja Orihuela, Alicante, Spain
b Hospital General Universitario Morales Meseguer, Murcia, Spain
This item has received
Received 02 January 2024. Accepted 12 March 2024
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Tables (6)
Table 1. Sociodemographic, clinical, and evolutionary characteristics at the ICU stay.
Table 2. Physical, cognitive, and mental changes at the first post-ICU consultation.
Table 3. Physical and neuropsychological sequelae in second post-ICU consultation.
Table 4. Yearly evolution.
Table 5. Predictive factors of PICS-P.
Table 6. Sociodemographic, clinical, and evolutionary characteristics. Propensity Score Matching Analysis.
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Additional material (1)
Abstract
Objective

Compare prevalence and profile of post-intensive care patient (P-PICS) and family/caregiver (F-PICS) syndrome in two cohorts (COVID and non-COVID) and analyse risk factors for P-PICS.

Design

Prospective, observational cohort (March 2018–2023), follow-up at three months and one year.

Setting

14-bed polyvalent Intensive Care Unit (ICU), Level II Hospital.

Patients or participants

265 patients and 209 relatives. Inclusion criteria patients: age > 18 years, mechanical ventilation > 48 h, ICU stay > 5 days, delirium, septic shock, acute respiratory distress syndrome, cardiac arrest. Inclusion criteria family: those who attended.

Interventions

Follow-up 3 months and 1 year after hospital discharge.

Main variables of interest

Patients: sociodemographic, clinical, evolutive, physical, psychological and cognitive alterations, dependency degree and quality of life. Main caregivers: mental state and physical overload.

Results

64.9% PICS-P, no differences between groups. COVID patients more physical alterations than non-COVID (P = .028). These more functional deterioration (P = .005), poorer quality of life (P = .003), higher nutritional alterations (P = .004) and cognitive deterioration (P < .001). 19.1% PICS-F, more frequent in relatives of non-COVID patients (17.6% vs. 5.5%; P = .013). Independent predictors of PICS-P: first years of the study (OR: 0.484), higher comorbidity (OR: 1.158), delirium (OR: 2.935), several reasons for being included (OR: 3.171) and midazolam (OR: 4.265).

Conclusions

Prevalence PICS-P and PICS-F between both cohorts was similar. Main factors associated with the development of SPCI-P were: higher comorbidity, delirium, midazolan, inclusion for more than one reason and during the first years.

Keywords:
Post-intensive care syndrome
Patient
Primary caregiver
COVID
Physical sphere
Cognitive sphere
Psychic sphere
Quality of life
Resumen
Objetivo

Comparar prevalencia y características del síndrome post-cuidados intensivos paciente (SPCI-P) y familiar/cuidador (SPCI-F) en dos cohortes (COVID y no COVID) y analizar factores riesgo de SPCI-P.

Diseño

Prospectivo, observacional cohortes (Marzo 2018–2023), seguimiento a tres meses y año.

Ámbito

Unidad de Cuidados Intensivos (UCI) polivalente 14 camas, Hospital Nivel II.

Pacientes o participantes

Pacientes: 265, familiares: 209. Criterios inclusión pacientes: edad > 18 años, ventilación mecánica > 48 horas, estancia UCI > 5 días, delirium, shock séptico, síndrome distrés respiratorio agudo, parada cardiaca. Criterios inclusión familiares: acudir consulta.

Intervenciones

Seguimiento 3 meses y año del alta hospitalaria.

Variables de interés principales

Pacientes: sociodemográficas, clínicas, evolutivas, alteraciones físicas, psíquicas y cognitivas, dependencia y calidad de vida. Familiares: estado mental y sobrecarga física.

Resultados

SPCI-P 64,9%, sin diferencias entre grupos. Pacientes COVID más alteraciones físicas que los no-COVID (P =,028). Estos últimos más deterioro funcional (P =,005), peor calidad de vida (P =,003), más alteraciones nutricionales (P =,004) y deterioro cognitivo (P <,001). 19,1% SPCI-F, más frecuente en familiares de pacientes no COVID (17,6% vs 5,5%; P =,013). Factores predictivos independientes de SPCI-P: primeros años estudio (OR: 0,484), mayor comorbilidad (OR: 1,158), delirium (OR: 2,935), varios motivos de inclusión consulta (OR: 3,171) y midazolan (OR: 4,265).

Conclusiones

Prevalencia de SPCI-P y SPCI-F similar en ambas cohortes. Principales factores asociados a SPCI-P: mayor comorbilidad, delirium, midazolan, haber sido incluido en la consulta por más de un motivo y primeros años del estudio.

Palabras clave:
Síndrome post-cuidados intensivos
Paciente
Cuidador principal
COVID
Esfera física
Esfera cognitiva
Esfera psíquica
Calidad de vida

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