American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 2020
Symptoms of Anxiety, Depression and Peritraumatic Dissociation in Critical Care Clinicians Managing COVID-19 Patients: A Cross-Sectional Study.
Rationale: Frontline healthcare providers (HCPs) during the coronavirus disease (COVID-19) pandemic are at high risk of mental morbidity. Objectives: To assess the prevalence of symptoms of anxiety, depression, and peritraumatic dissociation in HCPs. Methods: This was a cross-sectional study in 21 ICUs in France between April 20, 2020, and May 21, 2020. ⋯ Importantly, we identified the following six modifiable determinants of symptoms of mental health disorders: fear of being infected, inability to rest, inability to care for family, struggling with difficult emotions, regret about the restrictions in visitation policies, and witnessing hasty end-of-life decisions. Conclusions: HCPs experience high levels of psychological burden during the COVID-19 pandemic. Hospitals, ICU directors, and ICU staff must devise strategies to overcome the modifiable determinants of adverse mental illness symptoms.
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Am. J. Respir. Crit. Care Med. · Nov 2020
The Association Between Discharge Delay from Intensive Care and Patient Outcomes.
Rationale: ICU discharge delay occurs when a patient is considered ready to be discharged but remains in the ICU. The effect of discharge delay on patient outcomes is uncertain. Objectives: To investigate the association between discharge delay and patient outcomes including hospital mortality, readmission to ICU, and length of hospital stay after ICU discharge. ⋯ There was a progressive reduction in adjusted odds of readmission with increasing discharge delay. Conclusions: Increasing discharge delay in ICUs is associated with reduced likelihood of mortality and ICU readmission in high-risk patients. Consideration should be given to delay the discharge of patients with high risk of death on ICU admission.