Aishwarya, J (2023) Prevalence of Post-Intensive Care Syndrome in Critically-ill COVID Positive Patients. Masters thesis, Christian Medical College, Vellore.
Full text not available from this repository.Abstract
INTRODUCTION: Survivors of critical illness sustain many problems such as post-traumatic stress disorder, depression, anxiety, fatigue, weight loss, sleep disturbance, anxiety, depression because of which they have a poor quality of life, unemployment, and impaired social integration. The Society of Critical Care Medicine has termed these issues as post-intensive care syndrome (PICS). Post-intensive care syndrome (PICS) is a new term which defines any “new or worsening impairments in physical, cognitive, or mental health status arising after critical illness and persisting beyond acute care hospitalization”. OBJECTIVE: To determine the prevalence of post-intensive care syndrome in critically ill COVID patients through assessment of impairment in three domains- 1. Cognition, 2. Mental health, 3. Physical function. METHODS: This is a prospective cohort study wherein patients were assessed at 6 and 12 months since testing positive. Patients were contacted via telephone and telephonic consent was obtained. Patients were then assessed based on three domains – cognition, mental health and physical function using validated questionnaires – MoCA 5-min protocol for cognition, Hospital anxiety and depression scale for mental health and Barthel index for physical function. We also assessed for risk factors for occurrence of post-intensive care syndrome inclusive of demographic details, disease severity through the APACHE II score at admission, treatment data (duration of noninvasive and invasive ventilation, duration of hospital/ ICU stay, presence of organ dysfunction during ICU stay such as acute kidney injury requiring dialysis, and presence of hospital acquired infections such as Ventilator associated pneumonia, catheter-related blood stream infection and Urosepsis. RESULTS: In our study, we found that following a severe or critical COVID 19 infection, the prevalence of PICS was found to be 23.8% at 6-month follow-up and 57.3% in 12-month follow-up. The prevalence in our study was 13.6% at 6 month follow up and 40% at 12 month follow up. At the 6 month follow up, the risk factors identified to be statistically significant between the 2 groups were Age [OR] of 1.058, ( 95% CI 1.022-1.095, and p = 0.001), Charleson co-morbidity index ( [OR] of 1.532, 95% CI 1.165-2.015, and p = 0.002), Duration of hospital stay [ OR of 1.043, 95% CI 1.011–1.176, and p = 0.023), Need for tracheostomy during ICU stay [OR of 6.341, (95% CI 1.920-20.935) p= 0.003], Presence of ventilator associated pneumonia during hospital stay [OR of 2.750 95% CI 1.13-6.68) p= 0.022 ]. However, at 12-month follow-up, no statistically significant risk factors were identified in both the studies. CONCLUSION: Our study demonstrates the high prevalence of post-intensive care syndrome in COVID-19 patients and highlights the risk factors for the occurrence of the same. Hence, it is evident that there is a major need for interventions that reduce the incidence of PICS and for follow-up of these patients after discharge to provide appropriate rehabilitation interventions through multi-disciplinary approach.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 200120500002 |
| Uncontrolled Keywords: | Prevalence, Post-Intensive Care Syndrome, Critically-ill COVID Positive Patients. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 24 Jun 2021 13:01 |
| Last Modified: | 31 Jan 2024 02:45 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/17569 |
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