Síndrome post-cuidados intensivos al mes del alta hospitalaria de pacientes críticos supervivientes a COVID-19 / Post-intensive care syndrome at one month after hospital discharge in critically ill patients surviving COVID-19

Objetivos: Incidencia del síndrome post-cuidados intensivos al mes del alta hospitalaria en pacientes críticos supervivientes de COVID-19 e identificar factores asociados. Diseño: Estudio de cohortes prospectivo. Ámbito: Dos unidades de críticos polivalentes del Hospital Universitario Araba. Pacientes ingresados en unidades de críticos por insuficiencia respiratoria aguda grave secundaria a COVID-19. Intervención: Ninguna. Variables de interés: Variables demográficas, estancias, índice de Charlson, APACHEII, SOFA, días de ventilación mecánica, traqueotomía, delirio, tetraparesia del paciente crítico, EuroQol 5D5L, Minimental Test. Resultados: Se objetiva un deterioro en el índice de salud (IS) del EuroQol, que pasa de 90,9 ±16,9 a 70,9 ±24,7 (p<0,001). La afectación de los cinco dominios del EuroQol es de: movilidad (46,1%), actividades habituales (44,7%), malestar/dolor (30,7%), dominio psicológico (27,3%) y autocuidado (20,3%). El 61,5% sufren un descenso significativo de su índice de salud. El análisis multivariante mediante regresión logística nos muestra que el delirio (OR=3,01; IC95%: 1,01-8,9; p=0,047) y la traqueotomía (OR=2,37; IC95%: 1,09-5,14; p=0,029) muestran asociación con la caída en el IS del EuroQol 5D5L. El área bajo la curva ROC del modelo es del 67,3%, con un intervalo de confianza entre el 58% y el 76%. Se calibra el modelo mediante el test de Hosmer-Lemeshow:(χ2=0,468; p=0,792). Solamente el 1,2% de los pacientes mostraban una puntuación ≤24, claramente patológica, en el Minimental Test de Folstein. Conclusiones: El delirio y la necesidad de traqueostomía se asocian a síndrome post-cuidados intensivos evaluado mediante EuroQol 5D5L. (AU)

Objectives: Incidence of post-intensive care syndrome at one month after hospital discharge in surviving critically ill COVID-19 patients and to identify associated factors. Design: Prospective cohort study. Setting: Two multipurpose critical care units of the Araba University Hospital. Patients admitted to critical care units for severe acute respiratory failure secondary to COVID-19. Intervention: None. Variables of interest: Demographic variables, length of stay, Charlson index, APACHEII, SOFA, days of mechanical ventilation, tracheotomy, delirium, tetraparesis of the critical patient, EuroQol 5D5L, Minimental Test. Results: A deterioration in the EuroQol health index (HI) from 90.9 ±16.9 to 70.9 ±24.7 (P<.001) was observed. The impairment of the five EuroQol domains is: mobility (46.1%), usual activities (44.7%), discomfort/pain (30.7%), psychological domain (27.3%) and self-care (20.3%). The 61.5% suffer a significant decrease in their health index. Multivariate analysis by logistic regression shows us that delirium (OR=3.01; 95%CI: 1.01-8.9; P=.047) and tracheostomy (OR=2.37; 95%CI: 1.09-5.14; P=.029) show association with drop in EuroQol 5D5L SI. The area under the ROC curve of the model is 67.3%, with a confidence interval between 58% and 76%. The model is calibrated using the Hosmer-Lemeshow test (χ2=0.468; P=.792). Only 1.2% of patients showed a score ≤24, clearly pathological, on the Folstein's Minimental Test. Conclusions: Delirium and need for tracheostomy are associated with post-intensive care syndrome assessed by EuroQol 5D5L. (AU)

Post-intensive care syndrome one month after discharge in surviving critically ill COVID-19 patients.

OBJECTIVES: Incidence of post-intensive care syndrome at one month after hospital discharge in surviving critically ill COVID 19 patients and to identify associated factors. DESIGN: Prospective cohort study. SETTING: Two multipurpose critical care units of the Araba University Hospital. Patients admitted to critical care units for severe acute respiratory failure secondary to COVID 19. INTERVENTION: None. VARIABLES OF INTEREST: Demographic variables, length of stay, Charlson index, APACHE II, SOFA, days of mechanical ventilation, tracheotomy, delirium, tetraparesis of the critical patient, EuroQol 5D5L, Minimental Test. RESULTS: A deterioration in the EuroQol health index (HI) from 90.9±16.9 to 70.9±24.7 (p<0.001) was observed. The impairment of the five EuroQol domains is: mobility (46.1%), usual activities (44.7%), discomfort/pain (30.7%), psychological domain (27.3%) and self-care (20.3%). The 61.5% suffer a significant decrease in their health index. Multivariate analysis by logistic regression shows us that delirium (OR=3.01; 95%CI: 1.01-8.9; p=0.047) and tracheostomy (OR=2.37; 95%CI: 1.09-5.14; p=0.029) show association with drop in EuroQoL 5D5L SI. The area under the ROC curve of the model is 67.3%, with a confidence interval between 58% and 76%. The model is calibrated using the Hosmer-Lemeshow test (χ2=0.468; p=0.792). Only 1.2% of patients showed a score ≤ 24, clearly pathological, on the Folstein's Minimental Test. CONCLUSIONS: Delirium and need for tracheostomy are associated with post-intensive care syndrome assessed by EuroQol 5D5L.

[Post-intensive care syndrome one month after hospital discharge of critical patients surviving COVID 19.] / Síndrome post-cuidados intensivos al mes del alta hospitalaria de pacientes críticos supervivientes a COVID 19.

OBJECTIVES: incidence of post-intensive care syndrome at one month after hospital discharge in surviving critically ill COVID 19 patients and to identify associated factors. DESIGN: prospective cohort study. SETTING: two multipurpose critical care units of the Araba University Hospital.Patients admitted to critical care units for severe acute respiratory failure secondary to COVID 19. INTERVENTION: none. VARIABLES OF INTEREST: demographic variables, length of stay, Charlson index, APACHE II, SOFA, days of mechanical ventilation, tracheotomy, delirium, tetraparesis of the critical patient, EuroQol 5D5L, Minimental Test. RESULTS: a deterioration in the EuroQol health index (HI) from 90.9 ± 16.9 to 70.9 ± 24.7 (p < 0.001) was observed. The impairment of the five EuroQol domains is: mobility (46.1%), usual activities (44.7%), discomfort/pain (30.7%), psychological domain (27.3%) and self-care (20.3%). The 61.5% suffer a significant decrease in their health index. Multivariate analysis by logistic regression shows us that delirium (OR= 3.01; 95%CI: 1.01-8.9; p= 0.047) and tracheostomy (OR= 2.37; 95%CI: 1.09-5.14; p= 0.029) show association with drop in EuroQoL 5D5L SI. The area under the ROC curve of the model is 67.3%, with a confidence interval between 58% and 76%. The model is calibrated using the Hosmer-Lemeshow test:(χ2=0.468; p=0.792). Only 1.2% of patients showed a score ≤ 24, clearly pathological, on the Folstein's Minimental Test. CONCLUSIONS: delirium and need for tracheostomy are associated with post-intensive care syndrome assessed by EuroQol 5D5L.