TY - JOUR
T1 - Cognitive Function 3 and 12 Months After ICU Discharge-A Prospective Cohort Study
AU - Estrup, Stine
AU - Kjer, Cilia K.W.
AU - Vilhelmsen, Frederik
AU - Poulsen, Lone M.
AU - Gøgenur, Ismail
AU - Mathiesen, Ole
PY - 2018/12/1
Y1 - 2018/12/1
N2 - OBJECTIVES: Studies have shown impaired cognitive function after ICU discharge. We aimed to describe long-term cognitive function in Danish ICU patients. DESIGN: Prospective cohort study. SETTING: Single-center ICU at Zealand University Hospital, Køge, Denmark. PATIENTS: Adult patients admitted for over 24 hours. INTERVENTION: Three and 12 months after discharge, the patients were visited at home and tested with the Repeatable Battery for the Assessment of Neuropsychological Status. MEASUREMENTS AND MAIN RESULTS: We included 161 patients, 79 patients had a 3-month and 53 a 12-month follow-up visit. The primary reasons for not being visited at 3-month were death (44 patients), decline (26 patients), or transferal to another ICU (6 patients). Visited patients were median 67 years old (interquartile range, 59-73), had a median Acute Physiology and Chronic Health Evaluation score of 20 (interquartile range, 16-26), 58% were on a ventilator, and 30% were surgical patients. The mean Repeatable Battery for the Assessment of Neuropsychological Status score was 67 (SD, 21), compared with a normal value of 100 (15). A total of 57% had Repeatable Battery for the Assessment of Neuropsychological Status scores corresponding to moderate traumatic brain injury, 46% scored corresponding to light Alzheimer's disease, and 73% corresponding to mild cognitive impairment. After 12 months, the Repeatable Battery for the Assessment of Neuropsychological Status was still reduced (71 [25]). We examined protective and risk factors using multiple linear regression and found protective effects of being employed before admission (p = 0.0005) or being admitted from a surgical ward (p = 0.019). CONCLUSIONS: In this prospective cohort study of Danish ICU patients, we found significantly reduced cognitive function for intensive care patients 3 and 12 months after discharge.
AB - OBJECTIVES: Studies have shown impaired cognitive function after ICU discharge. We aimed to describe long-term cognitive function in Danish ICU patients. DESIGN: Prospective cohort study. SETTING: Single-center ICU at Zealand University Hospital, Køge, Denmark. PATIENTS: Adult patients admitted for over 24 hours. INTERVENTION: Three and 12 months after discharge, the patients were visited at home and tested with the Repeatable Battery for the Assessment of Neuropsychological Status. MEASUREMENTS AND MAIN RESULTS: We included 161 patients, 79 patients had a 3-month and 53 a 12-month follow-up visit. The primary reasons for not being visited at 3-month were death (44 patients), decline (26 patients), or transferal to another ICU (6 patients). Visited patients were median 67 years old (interquartile range, 59-73), had a median Acute Physiology and Chronic Health Evaluation score of 20 (interquartile range, 16-26), 58% were on a ventilator, and 30% were surgical patients. The mean Repeatable Battery for the Assessment of Neuropsychological Status score was 67 (SD, 21), compared with a normal value of 100 (15). A total of 57% had Repeatable Battery for the Assessment of Neuropsychological Status scores corresponding to moderate traumatic brain injury, 46% scored corresponding to light Alzheimer's disease, and 73% corresponding to mild cognitive impairment. After 12 months, the Repeatable Battery for the Assessment of Neuropsychological Status was still reduced (71 [25]). We examined protective and risk factors using multiple linear regression and found protective effects of being employed before admission (p = 0.0005) or being admitted from a surgical ward (p = 0.019). CONCLUSIONS: In this prospective cohort study of Danish ICU patients, we found significantly reduced cognitive function for intensive care patients 3 and 12 months after discharge.
UR - http://www.scopus.com/inward/record.url?scp=85056588540&partnerID=8YFLogxK
U2 - 10.1097/CCM.0000000000003391
DO - 10.1097/CCM.0000000000003391
M3 - Article
C2 - 30188383
AN - SCOPUS:85056588540
SN - 0090-3493
VL - 46
SP - e1121-e1127
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 12
ER -