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Agbakou M, Combet M, Martin M, Blonz G, Desmedt L, Seguin A, Lemarié J, Zambon O, Reignier J, Lascarrou JB, Ehrmann S, Canet E. Post-intensive care syndrome screening: a French multicentre survey. Ann Intensive Care 2024; 14:109. [PMID: 38980434 PMCID: PMC11233491 DOI: 10.1186/s13613-024-01341-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 06/21/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Post-intensive care syndrome (PICS), defined as physical, cognitive, and mental-health symptoms persisting long after intensive-care-unit (ICU) discharge, is increasingly recognised as a healthcare priority. Data on screening for PICS are sparse. Our objective here was to describe post-ICU screening in France, with special attention to visit availability and evaluations done during visits. METHODS We conducted an online multicentre survey by emailing an anonymous 43-item questionnaire to French ICUs. For each ICU, a single survey was sent to either the head or the intensivist in charge of follow-up visits. RESULTS Of 252 ICUs invited to participate, 161 (63.9%) returned the completed survey. Among them, 46 (28.6%) offered follow-up visits. Usually, a single visit led by an intensivist was scheduled 3 to 6 months after ICU discharge. Approximately 50 patients/year/ICU, that is, about 5% of admitted patients, attended post-ICU visits. The main criteria used to select patients for follow-up were ICU stay and/or invasive mechanical ventilation duration longer than 48 h, cardiac arrest, septic shock, and acute respiratory distress syndrome. Among ICUs offering visits, 80% used validated instruments to screen for PICS. Of the 115 ICUs not offering follow-up, 50 (43.5%) indicated an intention to start follow-up within the next year. The main barriers to offering follow-up were lack of available staff and equipment or not viewing PICS screening as a priority. Half the ICUs offering visits worked with an established network of post-ICU care professionals, and another 17% were setting up such a network. Obstacles to network creation were lack of interest among healthcare professionals and lack of specific training in PICS. CONCLUSION Only a small minority of ICU survivors received follow-up designed to detect PICS. Less than a third of ICUs offered follow-up visits but nearly another third planned to set up such visits within the next year. Recommendations issued by French health authorities in 2023 can be expected to improve the availability and standardisation of post-ICU follow-up.
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Affiliation(s)
- Maïté Agbakou
- Intensive Care Unit, Nantes University Hospital, Nantes University, 30 Bd. Jean Monnet, Nantes, Cedex 1 44093, France.
| | - Margot Combet
- Intensive Care Unit, Kremlin-Bicêtre University Hospital, Assistance Publique- Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Maëlle Martin
- Intensive Care Unit, Nantes University Hospital, Nantes University, 30 Bd. Jean Monnet, Nantes, Cedex 1 44093, France
| | - Gauthier Blonz
- Intensive Care Unit, Nantes University Hospital, Nantes University, 30 Bd. Jean Monnet, Nantes, Cedex 1 44093, France
| | - Luc Desmedt
- Intensive Care Unit, Nantes University Hospital, Nantes University, 30 Bd. Jean Monnet, Nantes, Cedex 1 44093, France
| | - Amélie Seguin
- Intensive Care Unit, Nantes University Hospital, Nantes University, 30 Bd. Jean Monnet, Nantes, Cedex 1 44093, France
| | - Jérémie Lemarié
- Intensive Care Unit, Nantes University Hospital, Nantes University, 30 Bd. Jean Monnet, Nantes, Cedex 1 44093, France
| | - Olivier Zambon
- Intensive Care Unit, Nantes University Hospital, Nantes University, 30 Bd. Jean Monnet, Nantes, Cedex 1 44093, France
| | - Jean Reignier
- Intensive Care Unit, Nantes University Hospital, Movement - Interactions - Performance Research Unit (MIP, (MIP, UR 4334), Nantes, France
| | - Jean-Baptiste Lascarrou
- Intensive Care Unit, Nantes University Hospital, Nantes University, 30 Bd. Jean Monnet, Nantes, Cedex 1 44093, France
| | - Stephan Ehrmann
- Intensive Care Unit, Tours University Hospital, Tours, France
- INSERM CIC 1415, Tours University, Tours University Hospital, Tours, France
- Research Center for Respiratory Diseases, INSERM U110, Tours University, Tours, France
- Clinical Research in Intensive Care and Sepsis-Trial Group for Global Evaluation and Research in Sepsis (CRICS_TRIGGERSep), Tours, France
| | - Emmanuel Canet
- Intensive Care Unit, Nantes University Hospital, Nantes University, 30 Bd. Jean Monnet, Nantes, Cedex 1 44093, France
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Pietruszka-Wałęka E, Rząd M, Rożyńska R, Miklusz P, Zieniuk-Lesiak E, Żabicka M, Jahnz-Różyk K. Quality of Life in Follow-Up up to 9 Months after COVID-19 Hospitalization among the Polish Population-A Prospective Single Center Study. Biomedicines 2024; 12:1282. [PMID: 38927489 PMCID: PMC11201014 DOI: 10.3390/biomedicines12061282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
The consequences of COVID-19 constitute a significant burden to healthcare systems worldwide. Conducting an HRQoL assessment is an important aspect of the evaluation of the impact of the disease. The aim of this study was to investigate the prevalence of persistent symptoms and their impact on HRQoL and health status in COVID-19 convalescents. The study group consists of 46 patients who required hospitalization due to respiratory failure and who were subsequently evaluated 3 and 9 months after hospital discharge. At the follow-up visits, the patients were asked to assess their HRQoL using the EQ-5D-5L questionnaire. The results of chest CT, 6MWT, as well as the severity of the course of COVID-19 were also considered in the analysis. The obtained results have identified fatigue as the most common persistent symptom. The majority of the convalescents reported an impairment of HRQoL in at least one domain (80% and 82% after 3 and 9 months, respectively), of which the most common was that of pain/discomfort. The presence of ongoing symptoms may affect HRQoL in particular domains. The 6MWT outcome correlates with HRQoL 3 months after hospital discharge. Therefore, it may be useful in identifying patients with reduced HRQoL, allowing early interventions aimed at its improvement.
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Affiliation(s)
- Ewa Pietruszka-Wałęka
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Michał Rząd
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Renata Rożyńska
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Piotr Miklusz
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Emilia Zieniuk-Lesiak
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Magdalena Żabicka
- Department of Radiology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Karina Jahnz-Różyk
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
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Miori S, Sanna A, Lassola S, Cicolini E, Zanella R, Magnoni S, De Rosa S, Bellani G, Umbrello M. Incidence, Risk Factors, and Consequences of Post-Traumatic Stress Disorder Symptoms in Survivors of COVID-19-Related ARDS. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5504. [PMID: 37107786 PMCID: PMC10138688 DOI: 10.3390/ijerph20085504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/28/2023] [Accepted: 04/06/2023] [Indexed: 05/11/2023]
Abstract
Purpose: To assess the prevalence of symptoms of Post-Traumatic Stress Disorder (PTSD) in survivors of COVID-19 Acute Respiratory Distress Syndrome that needed ICU care; to investigate risk factors and their impact on the Health-Related Quality of life (HR-QoL). Materials and Methods: This multicenter, prospective, observational study included all patients who were discharged from the ICU. Patients were administered the European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire, the Short-Form Health Survey 36Version 2 (SF-36v2), a socioeconomic question set and the Impact of Event Scale-Revised (IES-R) to assess PTSD. Results: The multivariate logistic regression model found that an International Standard Classification of Education Score (ISCED) higher than 2 (OR 3.42 (95% CI 1.28-9.85)), monthly income less than EUR 1500 (OR 0.36 (95% CI 0.13-0.97)), and more than two comorbidities (OR 4.62 (95% CI 1.33-16.88)) are risk factors for developing PTSD symptoms. Patients with PTSD symptoms are more likely to present a worsening in their quality of life as assessed by EQ-5D-5L and SF-36 scales. Conclusion: The main factors associated with the development of PTSD-related symptoms were a higher education level, a lower monthly income, and more than two comorbidities. Patients who developed symptoms of PTSD reported a significantly lower Health-Related Quality of life as compared to patients without PTSD. Future research areas should be oriented toward recognizing potential psychosocial and psychopathological variables capable of influencing the quality of life of patients discharged from the intensive care unit to better recognize the prognosis and longtime effects of diseases.
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Affiliation(s)
- Sara Miori
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, 38122 Trento, Italy
| | - Andrea Sanna
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, 38122 Trento, Italy
| | - Sergio Lassola
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, 38122 Trento, Italy
| | - Erica Cicolini
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, 38122 Trento, Italy
| | - Roberto Zanella
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, 38122 Trento, Italy
| | - Sandra Magnoni
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, 38122 Trento, Italy
| | - Silvia De Rosa
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, 38122 Trento, Italy
- Centre for Medical Sciences—CISMed, University of Trento, 38122 Trento, Italy
| | - Giacomo Bellani
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, 38122 Trento, Italy
- Centre for Medical Sciences—CISMed, University of Trento, 38122 Trento, Italy
| | - Michele Umbrello
- Department of Intensive Care Unit, San Carlo Borromeo University Hospital, 20142 Milan, Italy
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Sanfilippo F, La Via L, Schembari G, Tornitore F, Zuccaro G, Morgana A, Valenti MR, Oliveri F, Pappalardo F, Astuto M. Implementation of video-calls between patients admitted to intensive care unit during the COVID-19 pandemic and their families: a pilot study of psychological effects. JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE 2022; 2:38. [PMID: 37386565 PMCID: PMC9397160 DOI: 10.1186/s44158-022-00067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has caused over 530 million infections to date (June 2022), with a high percentage of intensive care unit (ICU) admissions. In this context, relatives have been restricted from visiting their loved ones admitted to hospital. This situation has led to an inevitable separation between patients and their families. Video communication could reduce the negative effects of such phenomenon, but the impact of this strategy on levels of anxiety, depression, and PTSD disorder in caregivers is not well-known. METHODS We conducted a prospective study (6 October 2020-18 February 2022) at the Policlinico University Hospital in Catania, including caregivers of both COVID-19 and non-COVID-19 ICU patients admitted during the second wave of the pandemic. Video-calls were implemented twice a week. Assessment of anxiety, depression, and PTSD was performed at 1-week distance (before the first, T1, and before the third, video-call, T2) using the following validated questionnaires: Impact of Event Scale (Revised IES-R), Center for Epidemiologic Studies Depression Scale (CES-D), and Hospital Anxiety and Depression Scale (HADS). RESULTS Twenty caregivers of 17 patients completed the study (T1 + T2). Eleven patients survived (n = 9/11 in the COVID-19 and n = 2/6 in the "non-COVID" group). The average results of the questionnaires completed by caregivers between T1 and T2 showed no significant difference in terms of CES-D (T1 = 19.6 ± 10, T2 = 22 ± 9.6; p = 0.17), HADS depression (T1 = 9.5 ± 1.6, T2 = 9 ± 3.9; p = 0.59), HADS anxiety (T1 = 8.7 ± 2.4, T2 = 8.4 ± 3.8; p = 0.67), and IES-R (T1 = 20.9 ± 10.8, T2 = 23.1 ± 12; p = 0.19). Similar nonsignificant results were observed in the two subgroups of caregivers (COVID-19 and "non-COVID"). However, at T1 and T2, caregivers of "non-COVID" patients had higher scores of CES-D (p = 0.01 and p = 0.04, respectively) and IES-R (p = 0.049 and p = 0.02, respectively), while HADS depression was higher only at T2 (p = 0.02). At T1, caregivers of non-survivors had higher scores of CES-D (27.6 ± 10.6 vs 15.3 ± 6.7, p = 0.005) and IES-R (27.7 ± 10.0 vs 17.2 ± 9.6, p = 0.03). We also found a significant increase in CES-D at T2 in ICU-survivors (p = 0.04). CONCLUSIONS Our preliminary results showed that a video-call implementation strategy between caregivers and patients admitted to the ICU is feasible. However, this strategy did not show an improvement in terms of the risk of depression, anxiety, and PTSD among caregivers. Our pilot study remains exploratory and limited to a small sample.
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Affiliation(s)
- Filippo Sanfilippo
- Department of Anaesthesia and Intensive Care, A.O.U. "Policlinico-San Marco", Catania, Italy.
| | - Luigi La Via
- Department of Anaesthesia and Intensive Care, A.O.U. "Policlinico-San Marco", Catania, Italy
| | - Giovanni Schembari
- School of Anaesthesia and Intensive Care, University "Magna Graecia", Catanzaro, Italy
| | - Francesco Tornitore
- School of Anaesthesia and Intensive Care, University "Magna Graecia", Catanzaro, Italy
| | - Gabriele Zuccaro
- School of Anaesthesia and Intensive Care, University "Magna Graecia", Catanzaro, Italy
| | - Alberto Morgana
- School of Anaesthesia and Intensive Care, University "Magna Graecia", Catanzaro, Italy
| | - Maria Rita Valenti
- Department of Anaesthesia and Intensive Care, A.O.U. "Policlinico-San Marco", Catania, Italy
| | - Francesco Oliveri
- Department of Anaesthesia and Intensive Care, A.O.U. "Policlinico-San Marco", Catania, Italy
| | - Federico Pappalardo
- Cardiothoracic and Vascular Anesthesia and Intensive Care, AO SS Antonio E Biagio E Cesare Arrigo, Alessandria, Italy
| | - Marinella Astuto
- Department of Anaesthesia and Intensive Care, A.O.U. "Policlinico-San Marco", Catania, Italy
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