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Mémoires Année : 2020

Health related quality of life and psychological disorders after intensive care : a single-center retrospective study

Résumé

Introduction : Recent studies reported a post intensive care syndrome and its consequences on the health-related quality of life (HRQOL). The aim of this study was to evaluate the HRQOL, the prevalence of PTSD, depression and anxiety after hospitalisation in intensive care unit.
Patients and Methods : We performed a single-center observational study between November 2012 and June 2018. We summoned ICU-survivor, with an admission Sepsis-related Organ Failure Assessment score higher than 4 or duration of mechanical ventilation > 48 hours, for a post-ICU follow-up 6 months after discharge. We collected demographic data and admissions diagnosis. We evaluated HRQOL, PTSD, anxiety and depression with the questionnaires Short-Form 36 (SF-36), Impact of Event Scale- Revised and the hospital anxiety and depression scale respectively.
Results : 354 patients attended the consultation at a median time of 7[6-8] months after ICU discharge. These patients exhibited alterations of the SF-36 score with the lowest for role limitation due to physical health, 0 [0-25] and role limitation related to emotion, 17 [0-50]. The best HRQOL scores were reported in cardiac arrest and neurological patients with a physical component score (PCS) of 58 [38-73] and 48 [34-66] respectively. The lowest values were found in septic shock and trauma patients with PCS of 36 [26-56] and 38 [23-53] respectively. We found a significant prevalence of anxiety (22%), depression (19%) and PTSD (17%). We found that male sex, neurological admission diagnosis, better mental component score MCS and shorter hospital LOS were associated with a PCS score above the median, and that anxiety, depression and better PCS were associated with a MCS above the median.
Conclusion : ICU-survivors present a low HRQOL mainly in SF-36 domains RE and RP, 6 months after ICU. Cardiac arrest and neurological patients seem to exhibit the best HRQOL whereas septic shock and trauma patients present the worst. Anxiety, depression and PTSD were found in around one patient in five without difference across admission diagnosis. Male gender, admission for neurological reason, shorter hospital length of stay, absence of anxiety or depression are associated with better HRQOL 6 months after ICU discharge.
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Dates et versions

dumas-03116264 , version 1 (20-01-2021)

Identifiants

  • HAL Id : dumas-03116264 , version 1

Citer

Éric Freydier. Health related quality of life and psychological disorders after intensive care : a single-center retrospective study. Human health and pathology. 2020. ⟨dumas-03116264⟩
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