Two-year trajectory of functional recovery and quality of life in post-intensive care syndrome: a multicenter prospective observational study on mechanically ventilated patients with coronavirus disease-19.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hatakeyama Junji, Nakamura Kensuke, Inoue Shigeaki, Liu Keibun, Yamakawa Kazuma, Nishida Takeshi, Ohshimo Shinichiro, Hashimoto Satoru, Kanda Naoki, Aso Shotaro, Suganuma Shinya, Maruyama Shuhei, Ogata Yoshitaka, Takasu Akira, Kawakami Daisuke, Shimizu Hiroaki, Hayakawa Katsura, Yoshida Takeshi, Oshima Taku, Fuchigami Tatsuya, Yawata Hironori, Oe Kyoji, Kawauchi Akira, Yamagata Hidehiro, Harada Masahiro, Sato Yuichi, Nakamura Tomoyuki, Sugiki Kei, Hakozaki Takahiro, Beppu Satoru, Anraku Masaki, Kato Noboru, Iwashita Tomomi, Kamijo Hiroshi, Kitagawa Yuichiro, Nagashima Michio, Nishimaki Hirona, Tokuda Kentaro, Nishida Osamu
Аннотация
METHODS: Patients who survived COVID-19 requiring mechanical ventilation completed questionnaires on the Barthel index, Short-Memory Questionnaire, Hospital Anxiety and Depression Scale, and EuroQol 5 dimensions 5-level every six months over a two-year period. Scores were weighted to account for dropouts, and the trajectory of each functional impairment was evaluated with alluvial diagrams. The prevalence of PICS and factors impairing or restoring function were examined using generalized estimating equations considering trajectories.
RESULTS: Among 334 patients, PICS prevalence rates in the four completed questionnaires were 72.1, 78.5, 77.6, and 82.0%, with cognitive impairment being the most common and lower QOL being noted when multiple impairments coexisted. Physical function and QOL indicated that many patients exhibited consistent trends of either recovery or deterioration. In contrast, cognitive function and mental health revealed considerable variability, with many patients showing fluctuating ratings in the later surveys. Delirium was associated with worse physical and mental health and poor QOL, while prolonged ventilation was associated with poor QOL. Living with family was associated with the recovery of all functions and QOL, while extracorporeal membrane oxygenation (ECMO) was associated with the recovery of cognitive function and mental health.
CONCLUSIONS: Critically ill patients had PICS for a long period and followed different trajectories for each impairment component. Based on trajectories, known PICS risk factors such as prolonged ventilation and delirium were associated with impaired recovery, while ECMO and the presence of family were associated with recovery from PICS. In critically ill COVID-19 patients, delirium management and family interventions may play an important role in promoting recovery from PICS.
TRIAL REGISTRATION NUMBER: UMIN000041276, August 01, 2020.