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( Ryoung-eun Ko ),( Chi Ryang Chung ),( Taewan Kim ),( Ire Heo ),( Areum Han ),( Chaiyoung Lee ),( Yunjoo Im ),( Gee Young Suh ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0
Background Previous studies have shown that intensive care unit (ICU) survivors are affected by a wide range of physical, cognitive, and psychiatric issues. Among post intensive care syndrome, cognitive impairment and psychiatric problems worsen the quality of life of ICU survivors, and they have become important public health issues. Delirium is a frequent disorder in ICU and is associated with substantially increased morbidity and mortality after ICU care. This study conducted to evaluate the association between the presence of delirium during hospitalization involving ICU care and post-discharge cognitive impairment or psychiatric problems. Methods We conducted a retrospective cohort study using a database of nationwide insurance claims data. All patients aged 18 years or older who were admitted to an ICU between January 1, 2008, and May 31, 2015, and had no history of previous cognitive impairment or psychiatric problems were included. Results Of 306,011 patients, the proportion of those who experienced delirium during hospitalization was 55.0% (n = 168,190). The patients with delirium during hospitalization had significantly increased odds for cognitive impairment (adjusted HR 1.17; 95% CI, 1.05-1.29) and psychiatric problems (adjusted HR 1.78; 95% CI, 1.67-1.90) after discharge compared with patients without delirium. In patients who had delirium, the incidence of cognitive impairment was 210.8 per 1,000 person-years. In 19,496 patients who were diagnosed with cognitive impairment, depression (n = 3,233, 16.5%), sleep disorder (n = 1,791, 9.2%), and anxiety (n = 1,683, 8.6%) were commonly co-diagnosed. The most common psychiatric problem was sleep disorder (148.7 per 1,000 person-years), followed by depression (133.3 per 1,000 person-years). Conclusions Among patients received ICU care, those who experienced delirium during hospitalization had an increased risk of developing cognitive impairment or psychiatric problems post-discharge. Many patients showed multiple cognitive impairment and psychiatric problems during the follow-up period.
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