BMJ open · 2023
Relationship between grip strength during hospitalisation and mental disorders after discharge in critically ill patients: a post-hoc analysis of a prospective observational study.
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Notsuyu Ayano, Naraba Hiromu, Liu Keibun, Ikechi Daisuke, Nakano Hidehiko, Mochizuki Masaki, Takahashi Yuji, Watanabe Shinichi, Morita Yasunari, Kotani Toru, Nakamura Kensuke
Аннотация
OBJECTIVES: Post-intensive care syndrome (PICS) is a recognised sequela after critical care. The development of an index that predicts PICS mental disorders will be of significance for the selection of subsequent interventions. The purpose of this study was to find factors associated with PICS mental disorders. We hypothesised that grip strength during hospitalisation may be associated with the PICS mental status after discharge.
DESIGN: A post-hoc analysis of a multicentre prospective observational study.
SETTING: Nine hospitals in Japan.
PARTICIPANTS: Patients who were newly admitted to intensive care unit and stayed for at least 48 hours were included. Exclusion criteria were patients younger than 18 years, those who required assistance with ambulation prior to admission, those with concomitant central nervous system disorders and those with terminal conditions.
PRIMARY AND SECONDARY OUTCOME MEASURES: Psychiatric symptoms 3 months after discharge were assessed using the Hospital Anxiety and Depression Scale (HADS). The HADS total score (HADS-total) was assigned as the primary outcome.
RESULTS: 98 patients were included into this study. Grip strength at discharge negatively correlated with HADS-total 3 months after discharge (r=-0.37, p<0.001, 95% CI -0.53 to -0.18). A multivariate analysis showed that grip strength was associated with anxiety (p=0.025, 95% CI -0.21 to -0.015). Area under the curve for HADS anxiety score with grip strength at discharge was higher than that with Medical Research Council scores and the Barthel Index (0.71, 0.60, 0.61).
CONCLUSIONS: Grip strength at discharge correlated with mental disorders 3 months after discharge. Therefore, it may be useful for predicting postdischarge mental disorders.
TRIAL REGISTRATION NUMBER: UMIN000036503.
DESIGN: A post-hoc analysis of a multicentre prospective observational study.
SETTING: Nine hospitals in Japan.
PARTICIPANTS: Patients who were newly admitted to intensive care unit and stayed for at least 48 hours were included. Exclusion criteria were patients younger than 18 years, those who required assistance with ambulation prior to admission, those with concomitant central nervous system disorders and those with terminal conditions.
PRIMARY AND SECONDARY OUTCOME MEASURES: Psychiatric symptoms 3 months after discharge were assessed using the Hospital Anxiety and Depression Scale (HADS). The HADS total score (HADS-total) was assigned as the primary outcome.
RESULTS: 98 patients were included into this study. Grip strength at discharge negatively correlated with HADS-total 3 months after discharge (r=-0.37, p<0.001, 95% CI -0.53 to -0.18). A multivariate analysis showed that grip strength was associated with anxiety (p=0.025, 95% CI -0.21 to -0.015). Area under the curve for HADS anxiety score with grip strength at discharge was higher than that with Medical Research Council scores and the Barthel Index (0.71, 0.60, 0.61).
CONCLUSIONS: Grip strength at discharge correlated with mental disorders 3 months after discharge. Therefore, it may be useful for predicting postdischarge mental disorders.
TRIAL REGISTRATION NUMBER: UMIN000036503.