The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors—a prospective cohort study
Abstract Background Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU s...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2018-01-01
|
Series: | Journal of Intensive Care |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s40560-017-0272-6 |
id |
doaj-d3b0d2d73ff746758f32491c3a76aa76 |
---|---|
record_format |
Article |
spelling |
doaj-d3b0d2d73ff746758f32491c3a76aa762020-11-24T22:03:05ZengBMCJournal of Intensive Care2052-04922018-01-01611810.1186/s40560-017-0272-6The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors—a prospective cohort studyEmily Brück0Anna Schandl1Matteo Bottai2Peter Sackey3Function Perioperative Medicine and Intensive Care, Karolinska University Hospital SolnaFunction Perioperative Medicine and Intensive Care, Karolinska University Hospital SolnaThe Unit of Biostatistics, Institute of Environmental Medicine, Karolinska InstitutetFunction Perioperative Medicine and Intensive Care, Karolinska University Hospital SolnaAbstract Background Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU survivors. The primary aim of this study was to examine the relationship between sepsis, ICU delirium, and later self-rated cognitive function. A second aim was to investigate the association between psychological problems and self-rated cognitive function 3 months after the ICU stay. Methods Patients staying more than 24 h at the general ICU at the Karolinska University Hospital Solna, Stockholm, Sweden, were screened for delirium with the Confusion Assessment Method-ICU (CAM-ICU) during their ICU stay. Sepsis incidence and severity were recorded. Three months later, 216 patients received the Cognitive Failures Questionnaire (CFQ), Hospital Anxiety and Depression Scale (HADS), and Post-Traumatic Stress Symptoms-10 (PTSS-10) questionnaires via postal mail. Results One hundred twenty-five patients (60%) responded to all questionnaires. Among respondents, the incidence of severe sepsis or septic shock was 42%. The overall incidence of delirium was 34%. Patients with severe sepsis/septic shock had a higher incidence of delirium, with an odds ratio (OR) of 3.7 (95% confidence interval (CI), 1.7–8.1). Self-rated cognitive problems 3 months post-ICU were found in 58% of the patients. We did not find any association between sepsis or delirium and late self-rated cognitive function. However, there was a correlation between psychological symptoms and self-rated cognitive function, with the strongest correlation between PTSS-10 scores and CFQ scores (r = 0.53; p < 0.001). Conclusions ICU delirium is more common in severely septic/septic shock patients. In our cohort, neither severe sepsis nor ICU delirium was associated with self-rated cognitive function 3 months after the ICU stay. Ongoing psychological symptoms, particularly post-traumatic stress was associated with worse self-rated cognitive function. Psychological symptoms need to be taken into account when assessing cognitive function in ICU survivors.http://link.springer.com/article/10.1186/s40560-017-0272-6Critical careIntensive care unitsDeliriumSepsisCognitive impairmentPost-traumatic stress symptoms |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Emily Brück Anna Schandl Matteo Bottai Peter Sackey |
spellingShingle |
Emily Brück Anna Schandl Matteo Bottai Peter Sackey The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors—a prospective cohort study Journal of Intensive Care Critical care Intensive care units Delirium Sepsis Cognitive impairment Post-traumatic stress symptoms |
author_facet |
Emily Brück Anna Schandl Matteo Bottai Peter Sackey |
author_sort |
Emily Brück |
title |
The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors—a prospective cohort study |
title_short |
The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors—a prospective cohort study |
title_full |
The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors—a prospective cohort study |
title_fullStr |
The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors—a prospective cohort study |
title_full_unstemmed |
The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors—a prospective cohort study |
title_sort |
impact of sepsis, delirium, and psychological distress on self-rated cognitive function in icu survivors—a prospective cohort study |
publisher |
BMC |
series |
Journal of Intensive Care |
issn |
2052-0492 |
publishDate |
2018-01-01 |
description |
Abstract Background Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU survivors. The primary aim of this study was to examine the relationship between sepsis, ICU delirium, and later self-rated cognitive function. A second aim was to investigate the association between psychological problems and self-rated cognitive function 3 months after the ICU stay. Methods Patients staying more than 24 h at the general ICU at the Karolinska University Hospital Solna, Stockholm, Sweden, were screened for delirium with the Confusion Assessment Method-ICU (CAM-ICU) during their ICU stay. Sepsis incidence and severity were recorded. Three months later, 216 patients received the Cognitive Failures Questionnaire (CFQ), Hospital Anxiety and Depression Scale (HADS), and Post-Traumatic Stress Symptoms-10 (PTSS-10) questionnaires via postal mail. Results One hundred twenty-five patients (60%) responded to all questionnaires. Among respondents, the incidence of severe sepsis or septic shock was 42%. The overall incidence of delirium was 34%. Patients with severe sepsis/septic shock had a higher incidence of delirium, with an odds ratio (OR) of 3.7 (95% confidence interval (CI), 1.7–8.1). Self-rated cognitive problems 3 months post-ICU were found in 58% of the patients. We did not find any association between sepsis or delirium and late self-rated cognitive function. However, there was a correlation between psychological symptoms and self-rated cognitive function, with the strongest correlation between PTSS-10 scores and CFQ scores (r = 0.53; p < 0.001). Conclusions ICU delirium is more common in severely septic/septic shock patients. In our cohort, neither severe sepsis nor ICU delirium was associated with self-rated cognitive function 3 months after the ICU stay. Ongoing psychological symptoms, particularly post-traumatic stress was associated with worse self-rated cognitive function. Psychological symptoms need to be taken into account when assessing cognitive function in ICU survivors. |
topic |
Critical care Intensive care units Delirium Sepsis Cognitive impairment Post-traumatic stress symptoms |
url |
http://link.springer.com/article/10.1186/s40560-017-0272-6 |
work_keys_str_mv |
AT emilybruck theimpactofsepsisdeliriumandpsychologicaldistressonselfratedcognitivefunctioninicusurvivorsaprospectivecohortstudy AT annaschandl theimpactofsepsisdeliriumandpsychologicaldistressonselfratedcognitivefunctioninicusurvivorsaprospectivecohortstudy AT matteobottai theimpactofsepsisdeliriumandpsychologicaldistressonselfratedcognitivefunctioninicusurvivorsaprospectivecohortstudy AT petersackey theimpactofsepsisdeliriumandpsychologicaldistressonselfratedcognitivefunctioninicusurvivorsaprospectivecohortstudy AT emilybruck impactofsepsisdeliriumandpsychologicaldistressonselfratedcognitivefunctioninicusurvivorsaprospectivecohortstudy AT annaschandl impactofsepsisdeliriumandpsychologicaldistressonselfratedcognitivefunctioninicusurvivorsaprospectivecohortstudy AT matteobottai impactofsepsisdeliriumandpsychologicaldistressonselfratedcognitivefunctioninicusurvivorsaprospectivecohortstudy AT petersackey impactofsepsisdeliriumandpsychologicaldistressonselfratedcognitivefunctioninicusurvivorsaprospectivecohortstudy |
_version_ |
1725833306976550912 |