Symptoms on the first day after discharge from the intensive care unit:A cross-sectional study

Abstract

Background: Data on intensive care unit (ICU) patients' symptom experiences shortly after ICU discharge are scarce.

Objectives: To determine prevalence, frequency, severity and distress of symptoms, and to investigate if possible predictive demographic and clinical factors are associated with a high number of symptoms the first day after ICU discharge.

Methods: In a cross-sectional study in Norway, thirty-two symptoms were evaluated in adult ICU survivors using the Memorial Symptom Assessment Scale. Data on prevalence (yes/no), frequency and severity (4-point scales) and distress (5-point scales) were collected. Possible associations between selected predictive demographic and clinical factors and having a high number (i.e.≥12) of symptoms were analysed using logistic regression analyses.

Results: The patients (n=155) reported a median of 12 symptoms (range:0-22). Lack of energy and dry mouth were most prevalent (83%). Lack of energy, dry mouth, and difficulty sleeping were most frequent (median=4). Problems with sexual interest/activity (median=3.5), lack of energy, dry mouth, difficulty sleeping, pain, vomiting, feeling sad and worrying were most severe (median=3), and problems with sexual interest/activity (median=4), difficulty sleeping, vomiting, feeling sad and worrying (median=3) were most distressing. Patients admitted to surgical wards were more than twice as likely to report a high number of symptoms (OR=2.23;95% CI [1.08,4.63]) than those admitted to medical wards (p=0.031).

Conclusions: Half of ICU survivors self-reported ≥12 symptoms the first day after ICU discharge. The most prevalent symptoms were not the most distressful, highlighting the need to screen for multiple symptoms and dimensions to provide target symptom relief and optimize rehabilitation.

Keywords: Critically ill; General wards; Intensive care unit; Multiple symptoms.