Long term cognitive dysfunction among critical care survivors: associated factors and quality of life—a multicenter cohort study

University of Porto. Faculty of Medicine. Department of Surgery and Physiology. Porto, Portugal / University of Porto. Faculty of Medicine. SIM-FMUP-Simulation Center. Porto, Portugal / University of Porto. CINTESIS-Center for Health Technology and Services Research. CriticalMed-Critical Care & Emergency Medicine. Porto, Portugal / Centro Hospitalar de Gaia/Espinho. Intensive Care Department. Vila Nova de Gaia, Portugal.
University of Porto. Faculty of Medicine. Information and Health Decision Sciences. Department of Community Medicine. Medicina da Comunidade, Informação e Decisão em Saúde. Porto, Portugal / University of Porto. Center for Health Technology and Services Research & Health Research Network Associated Laboratory. Porto, Portugal.
Research Unit. INOVA Medical. Porto Alegre, RS, Brazil.
Moinhos de Vento Hospital. Research Projects Office. Porto Alegre, RS, Brazil.
Moinhos de Vento Hospital. Research Projects Office. Porto Alegre, RS, Brazil.
Moinhos de Vento Hospital. Research Projects Office. Porto Alegre, RS, Brazil / Federal University of Rio Grande do Sul. Postgraduate Program in Epidemiology. Institute for Health Technology Assessment. Porto Alegre, RS, Brazil / Federal University of Rio Grande do Sul. Postgraduate Program in Epidemiology. Porto Alegre, RS, Brazil.
University of Porto. Faculty of Medicine. Information and Health Decision Sciences. Department of Community Medicine. Medicina da Comunidade, Informação e Decisão em Saúde. Porto, Portugal / University of Porto. Center for Health Technology and Services Research & Health Research Network Associated Laboratory. Porto, Portugal.
D'Or Institute for Research and Education. Department of Critical Care. Rio de Janeiro, RJ, Brazil.
Université Paris Cité. GHU Paris Psychiatrie Et Neurosciences Sainte-Anne Hospital Neurosciences of Paris. Institute of Psychiatry. Anesthesia and Intensive Care Department. Pole Neuro, Paris, France.
Moinhos de Vento Hospital. Department of Internal Medicine. Porto Alegre, RS, Brazil / Brazilian Research in Intensive Care Network. São Paulo, SP, Brazil.
University of Porto. Faculty of Medicine. Department of Surgery and Physiology. Porto, Portugal / University of Porto. Faculty of Medicine. SIM-FMUP-Simulation Center. Porto, Portugal / University of Porto. CINTESIS-Center for Health Technology and Services Research. CriticalMed-Critical Care & Emergency Medicine. Porto, Portugal / University of Porto. CINTESIS@RISE-Center for Health Technology and Services Research & Health Research Network Associated Laboratory. Porto, Portugal / University Hospital Center São João. Anaesthesiology Department. Porto, Portugal.
Brazilian Research in Intensive Care Network. São Paulo, SP, Brazil / Porto Alegre Clinical Hospital. Intensive Care Department. Porto Alegre, RS, Brazil / Federal University of Health Sciences of Porto Alegre. Medical School. Porto Alegre, RS, Brazil.

Resumen en ingles

Objectives: To identify the prevalence and associated factors of cognitive dysfunction, 1 year after ICU discharge, among adult patients, and it´s relation with quality of life. Methods: Multicenter, prospective cohort study including ICUs of 10 tertiary hospitals in Brazil, between May 2014 and December 2018. The patients included were 452 adult ICU survivors (median age 60; 47.6% women) with an ICU stay greater than 72 h. Results: At 12 months after ICU discharge, a Montreal Cognitive Assessment (tMOCA) telephone score of less than 12 was defined as cognitive dysfunction. At 12 months, of the 452 ICU survivors who completed the cognitive evaluation 216 (47.8%) had cognitive dysfunction. In multivariable analyses, the factors associated with long-term (1-year) cognitive dysfunction were older age (Prevalence Ratio-PR = 1.44, P < 0.001), absence of higher education (PR = 2.81, P = 0.005), higher comorbidities on admission (PR = 1.089; P = 0.004) and delirium (PR = 1.13, P < 0.001). Health-related Quality of life (HRQoL), assessed by the mental and physical dimensions of the SF-12v2, was significantly better in patients without cognitive dysfunction (Mental SF-12v2 Mean difference = 2.54; CI 95%, - 4.80/- 0.28; p = 0.028 and Physical SF-12v2 Mean difference = - 2.85; CI 95%, - 5.20/- 0.50; P = 0.018). Conclusions: Delirium was found to be the main modifiable predictor of long-term cognitive dysfunction in ICU survivors. Higher education consistently reduced the probability of having long-term cognitive dysfunction. Cognitive dysfunction significantly influenced patients' quality of life, leading us to emphasize the importance of cognitive reserve for long-term prognosis after ICU discharge.

Palabras clave en ingles

Long-term cognitive dysfunction
Critical care survivors
Follow-up
Cognitive reserve
Health-related quality of life
Delirium

Editor

Springer

Referencia

PEREIRA, Isabel Jesus et al. Long term cognitive dysfunction among critical care survivors: associated factors and quality of life—a multicenter cohort study. Annals of Intensive Care, v. 14, n. 116, p. 1-13, Jul. 2024.

DOI

10.1186/s13613-024-01335-w

ISSN

2110-5820

Notas

Fernando Augusto Bozza - Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Medicina Intensiva. Autor vinculado à Fiocruz, mas não consta à informação no documento.

Por favor, use este identificador para citar o enlazar este ítem: https://www.arca.fiocruz.br/handle/icict/65457

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