Neuropsychiatric outcome in subgroups of Intensive Care Unit survivors: Implications for after-care

Sandra M.A. Dijkstra-Kersten, Lotte Kok, Monika C. Kerckhoffs, Olaf L. Cremer, Dylan W. de Lange, Diederik van Dijk, Dale M. Needham, Arjen J.C. Slooter

Research output: Contribution to journalArticle

Abstract

Purpose: Poor neuropsychiatric outcomes are common in survivors of critical illness but it is unclear what patient groups to target for interventions to improve mental health. We compared anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms and health-related quality of life (HrQoL) across different subgroups of Intensive Care Unit (ICU) survivors. Materials and methods: A single-center cohort study was conducted in a mixed-ICU in the Netherlands among survivors of an ICU admission ≥48 h (n = 1730). Survivors received a survey one year after discharge, containing the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES/IES-R), and EQ-5D (response rate of 67%). Neuropsychiatric symptoms and quality of life were evaluated in a priori defined subgroups, by chi-square tests and Mann-Whitney U tests. Results: Symptoms of anxiety (HADS anxiety ≥8), depression (HADS depression ≥8), and PTSD (IES ≥35; IES-R ≥ 1.6) were reported by 34%, 33%, and 19% of ICU survivors, with a median HrQoL utility score of 0.81 (IQR:0.65–1.00). These figures were similar for survivors of ARDS, sepsis, severe multiple organ failure (SOFA>11), or ICU stay ≥7 days. Conclusions: This underlines the importance of prevention and treatment for neuropsychiatric symptoms in ICU survivors in general, not only in specific patient groups.

Original languageEnglish (US)
Pages (from-to)171-176
Number of pages6
JournalJournal of Critical Care
Volume55
DOIs
StatePublished - Feb 2020

Fingerprint

Intensive Care Units
Survivors
Anxiety
Depression
Quality of Life
Post-Traumatic Stress Disorders
Multiple Organ Failure
Chi-Square Distribution
Nonparametric Statistics
Critical Illness
Netherlands
Sepsis
Mental Health
Cohort Studies

Keywords

  • Anxiety
  • Critical illness
  • Depression
  • Intensive care unit
  • Posttraumatic stress disorder
  • Quality of life

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Dijkstra-Kersten, S. M. A., Kok, L., Kerckhoffs, M. C., Cremer, O. L., de Lange, D. W., van Dijk, D., ... Slooter, A. J. C. (2020). Neuropsychiatric outcome in subgroups of Intensive Care Unit survivors: Implications for after-care. Journal of Critical Care, 55, 171-176. https://doi.org/10.1016/j.jcrc.2019.11.006

Neuropsychiatric outcome in subgroups of Intensive Care Unit survivors : Implications for after-care. / Dijkstra-Kersten, Sandra M.A.; Kok, Lotte; Kerckhoffs, Monika C.; Cremer, Olaf L.; de Lange, Dylan W.; van Dijk, Diederik; Needham, Dale M.; Slooter, Arjen J.C.

In: Journal of Critical Care, Vol. 55, 02.2020, p. 171-176.

Research output: Contribution to journalArticle

Dijkstra-Kersten, SMA, Kok, L, Kerckhoffs, MC, Cremer, OL, de Lange, DW, van Dijk, D, Needham, DM & Slooter, AJC 2020, 'Neuropsychiatric outcome in subgroups of Intensive Care Unit survivors: Implications for after-care', Journal of Critical Care, vol. 55, pp. 171-176. https://doi.org/10.1016/j.jcrc.2019.11.006
Dijkstra-Kersten SMA, Kok L, Kerckhoffs MC, Cremer OL, de Lange DW, van Dijk D et al. Neuropsychiatric outcome in subgroups of Intensive Care Unit survivors: Implications for after-care. Journal of Critical Care. 2020 Feb;55:171-176. https://doi.org/10.1016/j.jcrc.2019.11.006
Dijkstra-Kersten, Sandra M.A. ; Kok, Lotte ; Kerckhoffs, Monika C. ; Cremer, Olaf L. ; de Lange, Dylan W. ; van Dijk, Diederik ; Needham, Dale M. ; Slooter, Arjen J.C. / Neuropsychiatric outcome in subgroups of Intensive Care Unit survivors : Implications for after-care. In: Journal of Critical Care. 2020 ; Vol. 55. pp. 171-176.
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abstract = "Purpose: Poor neuropsychiatric outcomes are common in survivors of critical illness but it is unclear what patient groups to target for interventions to improve mental health. We compared anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms and health-related quality of life (HrQoL) across different subgroups of Intensive Care Unit (ICU) survivors. Materials and methods: A single-center cohort study was conducted in a mixed-ICU in the Netherlands among survivors of an ICU admission ≥48 h (n = 1730). Survivors received a survey one year after discharge, containing the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES/IES-R), and EQ-5D (response rate of 67{\%}). Neuropsychiatric symptoms and quality of life were evaluated in a priori defined subgroups, by chi-square tests and Mann-Whitney U tests. Results: Symptoms of anxiety (HADS anxiety ≥8), depression (HADS depression ≥8), and PTSD (IES ≥35; IES-R ≥ 1.6) were reported by 34{\%}, 33{\%}, and 19{\%} of ICU survivors, with a median HrQoL utility score of 0.81 (IQR:0.65–1.00). These figures were similar for survivors of ARDS, sepsis, severe multiple organ failure (SOFA>11), or ICU stay ≥7 days. Conclusions: This underlines the importance of prevention and treatment for neuropsychiatric symptoms in ICU survivors in general, not only in specific patient groups.",
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