• Dimitry S Davydow, Douglas Zatzick, Catherine L Hough, and Wayne J Katon.
• 1 Department of Psychiatry and Behavioral Sciences, and.
• Ann Am Thorac Soc. 2013 Oct 1;10(5):450-7.

RationalePrior studies have found that cognitive dysfunction is common in intensive care unit (ICU) survivors. Yet, relatively little is known about potentially modifiable risk factors for longer-term post-ICU cognitive impairment.ObjectivesTo determine if in-hospital acute stress symptoms were associated with impaired 12-month cognitive functioning among ICU survivors.MethodsWe prospectively enrolled 150 nontrauma patients without cognitive impairment or a dementia diagnosis who were admitted to an ICU for more than 24 hours. Patients were interviewed before hospital discharge and again via telephone at 12 months post-ICU.Measurements And Main ResultsDemographics and clinical information were obtained through medical record reviews and in-person interviews. In-hospital acute stress symptoms were assessed with the Posttraumatic Stress Disorder Checklist-Civilian Version. Twelve-month post-ICU cognition was assessed with the modified Telephone Interview for Cognitive Status. Follow-up interviews were completed with 120 (80%) patients. Patients' mean age at hospitalization was 48.2 years (SD, 13.7). In unadjusted analyses, a greater number of in-hospital acute stress symptoms was associated with significantly greater impairment in 12-month cognitive functioning (β, -0.1; 95% confidence interval, -0.2 to -0.004; P = 0.04). After adjusting for patient and clinical factors, in-hospital acute stress symptoms were independently associated with greater impairment in 12-month cognitive functioning (β, -0.1; 95% CI, -0.2 to -0.01; P = 0.03).ConclusionsIn-hospital acute stress symptoms may be a potentially modifiable risk factor for greater impairment in cognitive functioning post-ICU. Early interventions for at-risk ICU survivors may improve longer-term outcomes.

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