@article{ref1,
title="Determinants of long-term physical and mental health outcomes after intensive care admission for trauma survivors",
journal="American journal of surgery",
year="2024",
author="Herrera-Escobar, Juan P. and Lamarre, Taylor and Rosen, Jordan and Ilkhani, Saba and Haynes, Ashley N. and Hau, Kaman and Jenkins, Kendall and Ruske, Jack and Wang, Joyce Y. and Serventi-Gleeson, Jessica and Sanchez, Sabrina E. and Kaafarani, Haytham Ma and Velmahos, George and Salim, Ali and Levy-Carrick, Nomi C. and Anderson, Geoffrey A.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: Collectively, studies from medical and surgical intensive care units (ICU) suggest that long-term outcomes are poor for patients who have spent significant time in an ICU. We sought to identify determinants of post-intensive care physical and mental health outcomes 6-12 months after injury. <br><br>METHODS: Adult trauma patients [ISS ≥9] admitted to one of three Level-1 trauma centers were interviewed 6-12 months post-injury to evaluate patient-reported outcomes. Patients requiring ICU admission ​≥ ​3 days (&quot;ICU patients&quot;) were compared with those who did not require ICU admission (&quot;non-ICU patients&quot;). Multivariable regression models were built to identify factors associated with poor outcomes among ICU survivors. <br><br>RESULTS: 2407 patients were followed [598 (25%) ICU and 1809 (75%) non-ICU patients]. Among ICU patients, 506 (85%) reported physical or mental health symptoms. Of them, 265 (52%) had physical symptoms only, 15 (3%) had mental symptoms only, and 226 (45%) had both physical and mental symptoms. In adjusted analyses, compared to non-ICU patients, ICU patients were more likely to have new limitations for ADLs (OR ​= ​1.57; 95% CI ​= ​1.21, 2.03), and worse SF-12 mental (mean Δ ​= ​-1.43; 95% CI ​= ​-2.79, -0.09) and physical scores (mean Δ ​= ​-2.61; 95% CI ​= ​-3.93, -1.28). Age, female sex, Black race, lower education level, polytrauma, ventilator use, history of psychiatric illness, and delirium during ICU stay were associated with poor outcomes in the ICU-admitted group. <br><br>CONCLUSIONS: Physical impairment and mental health symptoms following ICU stay are highly prevalent among injury survivors. Modifiable ICU-specific factors such as early liberation from ventilator support and prevention of delirium are potential targets for intervention.<p /> <p>Language: en</p>",
language="en",
issn="0002-9610",
doi="10.1016/j.amjsurg.2024.02.013",
url="http://dx.doi.org/10.1016/j.amjsurg.2024.02.013"
}