Early psychological screening of intensive care unit survivors: a prospective cohort study
Abstract Background A majority of patients survive their episode of critical illness but up to 30% of patients suffer from psychological problems such as post-traumatic stress, anxiety and depression in the year after intensive care unit (ICU) stay. A method to identify discharged patients at risk f...
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doaj-07a9c6f816b041d9b04fc040815eb9722020-11-25T01:21:24ZengBMCCritical Care1364-85352017-11-012111710.1186/s13054-017-1813-zEarly psychological screening of intensive care unit survivors: a prospective cohort studyAnna Milton0Emily Brück1Anna Schandl2Matteo Bottai3Peter Sackey4Department of Physiology and Pharmacology, Karolinska InstitutetDepartment of Physiology and Pharmacology, Karolinska InstitutetDepartment of Perioperative Medicine and Intensive Care, Karolinska University HospitalDepartment of Environmental Medicine, Karolinska InstitutetDepartment of Physiology and Pharmacology, Karolinska InstitutetAbstract Background A majority of patients survive their episode of critical illness but up to 30% of patients suffer from psychological problems such as post-traumatic stress, anxiety and depression in the year after intensive care unit (ICU) stay. A method to identify discharged patients at risk for adverse psychological outcome would be helpful in the triage for ICU follow-up and could enable early intervention. The aim of this study was to evaluate whether early screening with validated questionnaires after ICU discharge can identify patients at risk for symptoms of post-traumatic stress, anxiety and depression 3 months after ICU stay. Methods We performed a prospective observational cohort study in the general ICU at the Karolinska University Hospital Solna, Stockholm, Sweden. All adult patients surviving ≥ 24 hours in the ICU in a 9-month period were eligible for inclusion. Patients with mental disability, serious auditory and visual disorder, aphasia or who were unable to understand Swedish were excluded. One hundred and thirty-two patients were included and visited by a follow-up nurse within 1 week after ICU discharge. The Hospital Anxiety and Depression Scale (HADS) and the Post-Traumatic Stress Symptoms Checklist-10 (PTSS-10) were administered. Three months after ICU discharge the patients received the same questionnaires by postal mail. We assessed the predictive values of the questionnaires using the area under the receiver operating characteristic curve (AUROC). For correlation calculations, we used Spearman’s rank correlation coefficient. Negative and positive predictive values for each questionnaire were calculated. Results Eighty-two patients returned the follow-up questionnaires. We found correlation between early and late scores and reasonable predictive precision regarding 3-month outcomes, with an AUROC of 0.90 for PTSS-10 part B, 0.80 for the HADS anxiety subscale and 0.75 for the HADS depression subscale. Conclusions Symptoms of post-traumatic stress, anxiety and depression assessed 1 week after ICU stay correlate with 3-month psychological outcome. The HADS and PTSS-10 may be useful aids to identify ICU survivors at high risk for clinically significant symptoms of post-traumatic stress, anxiety and depression 3 months post ICU stay.http://link.springer.com/article/10.1186/s13054-017-1813-zCritical careIntensive care unitsStress disordersPost-traumaticAnxietyDepression |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anna Milton Emily Brück Anna Schandl Matteo Bottai Peter Sackey |
spellingShingle |
Anna Milton Emily Brück Anna Schandl Matteo Bottai Peter Sackey Early psychological screening of intensive care unit survivors: a prospective cohort study Critical Care Critical care Intensive care units Stress disorders Post-traumatic Anxiety Depression |
author_facet |
Anna Milton Emily Brück Anna Schandl Matteo Bottai Peter Sackey |
author_sort |
Anna Milton |
title |
Early psychological screening of intensive care unit survivors: a prospective cohort study |
title_short |
Early psychological screening of intensive care unit survivors: a prospective cohort study |
title_full |
Early psychological screening of intensive care unit survivors: a prospective cohort study |
title_fullStr |
Early psychological screening of intensive care unit survivors: a prospective cohort study |
title_full_unstemmed |
Early psychological screening of intensive care unit survivors: a prospective cohort study |
title_sort |
early psychological screening of intensive care unit survivors: a prospective cohort study |
publisher |
BMC |
series |
Critical Care |
issn |
1364-8535 |
publishDate |
2017-11-01 |
description |
Abstract Background A majority of patients survive their episode of critical illness but up to 30% of patients suffer from psychological problems such as post-traumatic stress, anxiety and depression in the year after intensive care unit (ICU) stay. A method to identify discharged patients at risk for adverse psychological outcome would be helpful in the triage for ICU follow-up and could enable early intervention. The aim of this study was to evaluate whether early screening with validated questionnaires after ICU discharge can identify patients at risk for symptoms of post-traumatic stress, anxiety and depression 3 months after ICU stay. Methods We performed a prospective observational cohort study in the general ICU at the Karolinska University Hospital Solna, Stockholm, Sweden. All adult patients surviving ≥ 24 hours in the ICU in a 9-month period were eligible for inclusion. Patients with mental disability, serious auditory and visual disorder, aphasia or who were unable to understand Swedish were excluded. One hundred and thirty-two patients were included and visited by a follow-up nurse within 1 week after ICU discharge. The Hospital Anxiety and Depression Scale (HADS) and the Post-Traumatic Stress Symptoms Checklist-10 (PTSS-10) were administered. Three months after ICU discharge the patients received the same questionnaires by postal mail. We assessed the predictive values of the questionnaires using the area under the receiver operating characteristic curve (AUROC). For correlation calculations, we used Spearman’s rank correlation coefficient. Negative and positive predictive values for each questionnaire were calculated. Results Eighty-two patients returned the follow-up questionnaires. We found correlation between early and late scores and reasonable predictive precision regarding 3-month outcomes, with an AUROC of 0.90 for PTSS-10 part B, 0.80 for the HADS anxiety subscale and 0.75 for the HADS depression subscale. Conclusions Symptoms of post-traumatic stress, anxiety and depression assessed 1 week after ICU stay correlate with 3-month psychological outcome. The HADS and PTSS-10 may be useful aids to identify ICU survivors at high risk for clinically significant symptoms of post-traumatic stress, anxiety and depression 3 months post ICU stay. |
topic |
Critical care Intensive care units Stress disorders Post-traumatic Anxiety Depression |
url |
http://link.springer.com/article/10.1186/s13054-017-1813-z |
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