TY - JOUR
T1 - Are intensive care factors associated with depressive symptoms 6 months after acute lung injury?
AU - Dowdy, David W.
AU - Bienvenu, Oscar Joseph
AU - Dinglas, Victor D.
AU - Mendez-Tellez, Pedro A.
AU - Sevransky, Jonathan
AU - Shanholtz, Carl
AU - Needham, Dale M.
PY - 2009/5
Y1 - 2009/5
N2 - Objective: To evaluate intensive care-related factors as predictors of depressive symptoms 6 months after acute lung injury (ALI). Design: Prospective cohort study. Setting: Thirteen intensive care units (ICUs) in four hospitals in Baltimore, MD. Patients: Consecutive ALI survivors (n = 160; 71% from medical ICUs) screened for depressive symptoms at 6 months post-ALI. Interventions: None. Measurements and Main Results: We prospectively measured 12 features of critical illness and ICU care and used multivariable regression to evaluate associations with depressive symptoms as measured by the Hospital Anxiety and Depression Score. The prevalence of a positive screening for depression (score >8) at 6 months post-ALI was 26%. Depressive symptoms were significantly associated with surgical (vs. medical or trauma) ICU admission (relative risk [RR] 2.2, 95% confidence interval [CI] 1.1-4.2), maximum daily Sequential Organ Failure Assessment Score of >10 (RR 2.1, 95% CI 1.1-3.5), and mean daily ICU benzodiazepine dose of >75 mg of midazolam equivalent (RR 2.1, 95% CI 1.1-3.5). Conclusions: Depressive symptoms at 6 months post-ALI are common and potentially associated with ICU-related factors. Mechanisms by which critical illness and intensive care management associate with depressive symptoms merit further investigation.
AB - Objective: To evaluate intensive care-related factors as predictors of depressive symptoms 6 months after acute lung injury (ALI). Design: Prospective cohort study. Setting: Thirteen intensive care units (ICUs) in four hospitals in Baltimore, MD. Patients: Consecutive ALI survivors (n = 160; 71% from medical ICUs) screened for depressive symptoms at 6 months post-ALI. Interventions: None. Measurements and Main Results: We prospectively measured 12 features of critical illness and ICU care and used multivariable regression to evaluate associations with depressive symptoms as measured by the Hospital Anxiety and Depression Score. The prevalence of a positive screening for depression (score >8) at 6 months post-ALI was 26%. Depressive symptoms were significantly associated with surgical (vs. medical or trauma) ICU admission (relative risk [RR] 2.2, 95% confidence interval [CI] 1.1-4.2), maximum daily Sequential Organ Failure Assessment Score of >10 (RR 2.1, 95% CI 1.1-3.5), and mean daily ICU benzodiazepine dose of >75 mg of midazolam equivalent (RR 2.1, 95% CI 1.1-3.5). Conclusions: Depressive symptoms at 6 months post-ALI are common and potentially associated with ICU-related factors. Mechanisms by which critical illness and intensive care management associate with depressive symptoms merit further investigation.
KW - Adult
KW - Critical care
KW - Depression
KW - Intensive care units
KW - Outcome assessment (health care)
KW - Respiratory distress syndrome
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U2 - 10.1097/CCM.0b013e31819fea55
DO - 10.1097/CCM.0b013e31819fea55
M3 - Article
C2 - 19357507
AN - SCOPUS:67649330256
SN - 0090-3493
VL - 37
SP - 1702
EP - 1707
JO - Critical care medicine
JF - Critical care medicine
IS - 5
ER -