• Am. J. Respir. Crit. Care Med. · Jun 2016

    Multicenter Study Observational Study

    Incidence and Risk Factors for ICU-related Posttraumatic Stress Disorder In Veterans and Civilians.

    • Mayur B Patel, James C Jackson, Alessandro Morandi, Timothy D Girard, Christopher G Hughes, Jennifer L Thompson, Amy L Kiehl, Mark R Elstad, Mitzi L Wasserstein, Richard B Goodman, Jean C Beckham, Rameela Chandrasekhar, Robert S Dittus, E Wesley Ely, and Pratik P Pandharipande.
    • 1 Surgical Services, Nashville VA Medical Center, Tennessee Valley Healthcare System, U.S. Department of Veterans Affairs, Nashville, Tennessee.
    • Am. J. Respir. Crit. Care Med. 2016 Jun 15; 193 (12): 1373-81.

    RationaleThe incidence and risk factors of post-traumatic stress disorder (PTSD) related to the intensive care unit (ICU) experience have not been reported in a mixed veteran and civilian cohort.ObjectivesTo describe the incidence and risk factors for ICU-related PTSD in veterans and civilians.MethodsThis is a prospective, observational, multicenter cohort enrolling adult survivors of critical illness after respiratory failure and/or shock from three Veterans Affairs and one civilian hospital. After classifying those with/without preexisting PTSD (i.e., PTSD before hospitalization), we then assessed all subjects for ICU-related PTSD at 3 and 12 months post hospitalization.Measurements And Main ResultsOf 255 survivors, 181 and 160 subjects were assessed for ICU-related PTSD at 3- and 12-month follow-up, respectively. A high probability of ICU-related PTSD was found in up to 10% of patients at either follow-up time point, whether assessed by PTSD Checklist Event-Specific Version (score ≥ 50) or item mapping using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). In the multivariable regression, preexisting PTSD was independently associated with ICU-related PTSD at both 3 and 12 months (P < 0.001), as was preexisting depression (P < 0.03), but veteran status was not a consistent independent risk factor for ICU-related PTSD (3-month P = 0.01, 12-month P = 0.48).ConclusionsThis study found around 1 in 10 ICU survivors experienced ICU-related PTSD (i.e., PTSD anchored to their critical illness) in the year after hospitalization. Preexisting PTSD and depression were strongly associated with ICU-related PTSD.

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