Format

Send to

Choose Destination
See comment in PubMed Commons below
Crit Care Med. 2014 Dec;42(12):2473-81. doi: 10.1097/CCM.0000000000000527.

Psychiatric symptoms and acute care service utilization over the course of the year following medical-surgical ICU admission: a longitudinal investigation*.

Author information

1
1Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA. 2Department of Medicine, University of Washington, Seattle, WA.

Abstract

OBJECTIVE:

To determine if the presence of in-hospital substantial acute stress symptoms, as well as substantial depressive or posttraumatic stress disorder symptoms at 3 months post-ICU, are associated with increased acute care service utilization over the course of the year following medical-surgical ICU admission.

DESIGN:

Longitudinal cohort study.

SETTING:

Academic medical center.

PATIENTS:

One hundred fifty patients who are 18 years old or older admitted to medical-surgical ICUs for over 24 hours.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Participants were interviewed in-hospital to ascertain substantial acute stress symptoms using the Posttraumatic Stress Disorder Checklist-Civilian version. Substantial depressive and posttraumatic stress disorder symptoms were assessed using the Patient Health Questionnaire-9 and the Posttraumatic Stress Disorder Checklist-Civilian version, respectively, at 3 months post-ICU. The number of rehospitalizations and emergency department visits were ascertained at 3 and 12 months post-ICU using the Cornell Services Index. After adjusting for participant and clinical characteristics, in-hospital substantial acute stress symptoms were independently associated with greater risk of an additional hospitalization (relative risk, 3.00; 95% CI, 1.80-4.99) over the year post-ICU. Substantial posttraumatic stress disorder symptoms at 3 months post-ICU were independently associated with greater risk of an additional emergency department visit during the subsequent 9 months (relative risk, 2.29; 95% CI, 1.09-4.84) even after adjusting for both rehospitalizations and emergency department visits between the index hospitalization and 3 months post-ICU.

CONCLUSIONS:

Post-ICU psychiatric morbidity is associated with increased acute care service utilization during the year after a medical-surgical ICU admission. Early interventions for at-risk ICU survivors may improve long-term outcomes and reduce subsequent acute care utilization.

PMID:
25083985
PMCID:
PMC4236258
DOI:
10.1097/CCM.0000000000000527
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments

    Supplemental Content

    Full text links

    Icon for Wolters Kluwer Icon for PubMed Central
    Loading ...
    Support Center