Prevalence of and risk factors for post-intensive care syndrome: Multicenter study of patients living at home after treatment in 12 Japanese intensive care units, SMAP-HoPe study.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Anxiety/*epidemiology ; Depression/*epidemiology ; Intensive Care Units/*statistics & numerical data ; Patient Discharge/*statistics & numerical data ; Stress Disorders, Post-Traumatic/*epidemiology ; Survivors/*statistics & numerical data; Aged ; Female ; Humans ; Japan/epidemiology ; Male ; Mental Health ; Middle Aged ; Prevalence ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires

Few studies have examined the epidemiology of post-intensive care syndrome in Japan. This study investigated the mental health and quality of life of patients living at home in Japan after intensive care unit (ICU) discharge. Additionally, we examined whether unplanned admission to the ICU was associated with more severe post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms. An ambidirectional cohort study was conducted at 12 ICUs in Japan. Patients who stayed in the ICU for > 3 nights and were living at home for 1 year afterward were included. One year after ICU discharge, we retrospectively screened patients and performed a mail survey on a monthly basis, including the Impact of Event Scale-Revised (IER-S), the Hospital Anxiety Depression Scale (HADS), and the EuroQOL-5 Dimension (EQ-5D-L) questionnaires. Patients' characteristics, delirium and coma status, drugs used, and ICU and hospital length of stay were assessed from medical records. Descriptive statistics and multilevel linear regression modeling were used to examine our hypothesis. Among 7,030 discharged patients, 854 patients were surveyed by mail. Of these, 778 patients responded (response rate = 91.1%). The data from 754 patients were analyzed. The median IES-R score was 3 (interquartile range [IQR] = 1‒9), and the prevalence of suspected PTSD was 6.0%. The median HADS anxiety score was 4.00 (IQR = 1.17‒6.00), and the prevalence of anxiety was 16.6%. The median HADS depression score was 5 (IQR = 2‒8), and the prevalence of depression was 28.1%. EQ-5D-L scores were lower in our participants than in the sex- and age-matched Japanese population. Unplanned admission was an independent risk factor for more severe PTSD, anxiety, and depressive symptoms. Approximately one-third of patients in the general ICU population experienced mental health issues one year after ICU discharge. Unplanned admission was an independent predictor for more severe PTSD symptoms.
Competing Interests: The authors have declared that no competing interests exist.

Crit Care Med. 2018 Oct;46(10):1673-1680. (PMID: 29985215)
Psychol Med. 2017 Oct;47(13):2260-2274. (PMID: 28385165)
Curr Opin Psychol. 2017 Apr;14:96-101. (PMID: 28813327)
Intensive Care Med. 2001 May;27(5):859-64. (PMID: 11430542)
Qual Life Res. 2011 Dec;20(10):1727-36. (PMID: 21479777)
Acta Psychiatr Scand. 1983 Jun;67(6):361-70. (PMID: 6880820)
Intensive Care Med. 2019 Jun;45(6):806-814. (PMID: 30840124)
BMC Med Res Methodol. 2017 Mar 27;17(1):49. (PMID: 28347296)
Crit Care. 2019 Aug 7;23(1):276. (PMID: 31391069)
East Asian Arch Psychiatry. 2018 Jun;28(2):39-44. (PMID: 29921739)
Crit Care. 2018 Nov 23;22(1):310. (PMID: 30466485)
Aust Crit Care. 2020 May;33(3):287-294. (PMID: 31839375)
Crit Care Med. 2016 Sep;44(9):1744-53. (PMID: 27153046)
Acute Med Surg. 2019 Apr 25;6(3):233-246. (PMID: 31304024)
Intensive Care Med. 2016 Nov;42(11):1733-1743. (PMID: 27695894)
Chest. 2021 Feb 25;:. (PMID: 33640377)
Rev Bras Ter Intensiva. 2017 Oct-Dec;29(4):418-426. (PMID: 29211187)
Crit Care. 2019 Jun 11;23(1):213. (PMID: 31186070)
JAMA. 2016 Feb 23;315(8):801-10. (PMID: 26903338)
J Nerv Ment Dis. 2002 Mar;190(3):175-82. (PMID: 11923652)
Crit Care. 2019 Dec 16;23(1):411. (PMID: 31842929)
Intensive Care Med. 2019 Feb;45(2):223-235. (PMID: 30701294)
Crit Care. 2020 Feb 4;24(1):37. (PMID: 32019601)
BMC Res Notes. 2016 Oct 22;9(1):479. (PMID: 27770833)
Anaesthesia. 2019 Jan;74(1):100-108. (PMID: 30291744)
JAMA. 2001 Dec 5;286(21):2703-10. (PMID: 11730446)
Value Health. 2016 Jul-Aug;19(5):648-54. (PMID: 27565282)
Crit Care Nurs Clin North Am. 2020 Jun;32(2):313-326. (PMID: 32402324)
Am J Respir Crit Care Med. 2016 Jun 15;193(12):1373-81. (PMID: 26735627)
JAMA. 2019 Feb 19;321(7):665-675. (PMID: 30776295)
Crit Care. 2021 Feb 16;25(1):69. (PMID: 33593406)
Crit Care. 2006;10(5):R147. (PMID: 17042955)
Rehabil Psychol. 2016 May;61(2):120-31. (PMID: 27196855)
J Hosp Med. 2017 Oct;12(10):831-835. (PMID: 28991949)
J Crit Care. 2015 Aug;30(4):793-8. (PMID: 25981443)
Acute Med Surg. 2020 Sep 01;7(1):e557. (PMID: 32995017)
Cerebrovasc Dis. 2013;36(2):126-30. (PMID: 24029667)
J Clin Nurs. 2019 Nov;28(21-22):3991-4003. (PMID: 31241805)
Crit Care Med. 2012 Feb;40(2):502-9. (PMID: 21946660)
Lancet Respir Med. 2014 May;2(5):369-79. (PMID: 24815803)
Gen Hosp Psychiatry. 2016 Nov - Dec;43:23-29. (PMID: 27796253)
Crit Care. 2010;14(1):R14. (PMID: 20144193)
BMC Psychiatry. 2020 May 12;20(1):220. (PMID: 32398018)
Nurs Open. 2021 Jan 2;:. (PMID: 33387449)
Am J Respir Crit Care Med. 2002 Nov 15;166(10):1338-44. (PMID: 12421743)
Nurs Crit Care. 2021 Mar;26(2):102-108. (PMID: 32734674)
Ann Am Thorac Soc. 2019 Aug;16(8):947-956. (PMID: 31162935)
PLoS One. 2020 Nov 30;15(11):e0242849. (PMID: 33253298)
Qual Life Res. 2016 Mar;25(3):707-19. (PMID: 26303761)
J Crit Care. 2020 Feb;55:86-94. (PMID: 31715536)
JAMA Pediatr. 2013 Jul;167(7):656-61. (PMID: 23699969)
Neurol Sci. 2020 Oct;41(10):2737-2746. (PMID: 32415640)
J Pak Med Assoc. 2017 Jun;67(6):884-888. (PMID: 28585587)

Date Created: 20210527 Date Completed: 20211022 Latest Revision: 20211022

20240513

PMC8158919

10.1371/journal.pone.0252167

34043682