Intensive care survivor-reported symptoms: a longitudinal study of survivors' symptoms

Anne Kathrine Langerud; Tone Rustøen; Milada Cvancarova Småstuen; Ulf Kongsgaard; Audun Stubhaug

doi:10.1111/nicc.12330

Intensive care survivor-reported symptoms: a longitudinal study of survivors' symptoms

Nurs Crit Care. 2018 Jan;23(1):48-54. doi: 10.1111/nicc.12330. Epub 2017 Dec 15.

Authors

Anne Kathrine Langerud^{1

2

3}, Tone Rustøen^{4

5}, Milada Cvancarova Småstuen⁶, Ulf Kongsgaard^{7

3}, Audun Stubhaug^{8

3}

Affiliations

¹ Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
² Department of Post-operative and Critical Care, Division of Emergencies and Critical Care Oslo University Hospital, Rikshospitalet, Oslo, Norway.
³ Faculty of Medicine, University of Oslo, Oslo, Norway.
⁴ Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Ullevål, Oslo, Norway.
⁵ Institute of Health and Society, Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway.
⁶ Faculty of Health Sciences, Oslo and Akershus University Collage of Applied Sciences, Oslo, Norway.
⁷ Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
⁸ Department of Pain Management and Reserch, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.

PMID: 29243344
DOI: 10.1111/nicc.12330

Abstract

Background: There is growing interest in potential long-term outcomes following intensive care, but few researchers have studied the prevalence of multiple symptoms or the association between pain and other symptoms.

Aims: To investigate the prevalence of anxiety, depression, fatigue, sleep disturbance and post-traumatic stress symptoms (PTSS) among intensive care survivors 3 months and 1 year after being discharged from an intensive care unit (ICU) and to determine whether pain is associated with higher prevalence of these symptoms 3 months and 1 year after ICU stay.

Study design: Exploratory, longitudinal cohort of intensive care survivors from two mixed ICUs in a tertiary referral hospital in Norway.

Methods: Intensive care survivors completed surveys at 3 months (n = 118) and 1 year (n = 89) after ICU discharge. Clinical Trials: NCT02279212.

Results: Prevalence rates of intensive care survivors' symptoms were pain 58 (49·2%), anxiety/depression 24/118 (20·8%), fatigue 18/118(15·3%), PTSS 15 (12·8%) and sleep disturbance 58/118 (49·2%) at 3 months after ICU discharge (n = 118). Prevalence rates at 1 year (n = 89) changed only slightly to pain 34 (38·2%), anxiety/depression 17 (20·0%), fatigue 12 (13·8%), PTSS 13 (15·1%) and sleep disturbance 40/89 (46·5%). Associations were strong between pain and presence of sleep disturbance, anxiety/depression, PTSS and fatigue.

Conclusions: Intensive care survivors have multiple symptoms and the prevalence rates of these symptoms remained almost unchanged from 3 months to 1 year after ICU discharge. The presence of pain was associated with high odds for the presence of sleep disturbance, anxiety/depression, PTSS and fatigue, compared to a no-pain group. ICU survivors may benefit from targeted interventions designed to alleviate the symptom burden.

Relevance to clinical practice: Knowledge about ICU survivor's prevalence and risk for having multiple symptoms may help health care professionals to give better care, if needed, to the ICU survivors.

Keywords: Adult intensive care; Clinical research; ICU follow-up; Intensive care unit survivor; Symptom.

MeSH terms

Anxiety / epidemiology*
Cohort Studies
Critical Care*
Depression / epidemiology*
Fatigue / epidemiology*
Female
Humans
Longitudinal Studies
Male
Middle Aged
Norway / epidemiology
Patient Discharge
Prevalence
Stress Disorders, Post-Traumatic / epidemiology
Surveys and Questionnaires
Survivors / psychology*

Associated data

ClinicalTrials.gov/NCT02279212