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Journal of critical care · Jun 2021
Observational StudyCombination of delirium and coma predicts psychiatric symptoms at twelve months in critically ill patients: A longitudinal cohort study.
- Kyohei Miyamoto, Mami Shibata, Nozomu Shima, Tsuyoshi Nakashima, Maki Kida, Haruka Matsumoto, Natsuki Oka, Akina Yazaki, Akiko Uchigaki, Aya Takemoto, Seiya Kato, and W-PICS Investigators.
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-8509, Wakayama, Japan. Electronic address: gomadofu@wakayama-med.ac.jp.
- J Crit Care. 2021 Jun 1; 63: 76-82.
PurposeWe aimed to determine any associations between delirium and comas during intensive care unit (ICU) stay, and long-term psychiatric symptoms and disability affecting activity of daily living (ADL).Materials And MethodsIn this prospective observational study, we enrolled critically ill adult patients that were emergently admitted to an ICU. We assessed psychiatric symptoms and disability affecting ADL at three and twelve months after ICU discharge.ResultsAmong the 81 and the 47 patients that responded to the questionnaires at three and twelve months, 22 (27%) and 13 (28%) patients experienced delirium, respectively. During their ICU stay, 28 (35%) and 21 (45%) had been in comas, respectively. At three and twelve months, 51 (63%) and 23 (49%) of patients experienced composite psychiatric symptoms or disability affecting ADL, respectively. After adjusting predefined confounders, the combination of delirium and comas was an independent risk factor for the presence of composite psychiatric symptoms or disability affecting ADL (adjusted odds ratio [aOR] 3.38; 1.10-10.38 at three months; aOR 8.28; 1.48-46.46 at twelve months).ConclusionsIn critically ill adults, combination of delirium and comas during ICU stay is a predictor of psychiatric symptoms or ADL disability.Trial RegistrationUMIN Clinical Trial Registry no. UMIN000023743, September 1, 2016.Copyright © 2021 Elsevier Inc. All rights reserved.
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