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Risk factors for long-term brain dysfunction after chronic critical illness
Aluko A Hope1, R Sean Morrison, Qingling Du
1Department of Medicine, Division of Critical Care Medicine, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10467, USA. ahope@montefiore.org
Annals of the American Thoracic Society
|August 20, 2013
Summary
Long-term brain dysfunction (LTBD) is common in chronic critical illness (CCI) survivors. Acute brain dysfunction during treatment, older age, and higher illness severity are key risk factors for LTBD.
Area of Science:
- Critical Care Medicine
- Neuroscience
- Public Health
Background:
- Long-term brain dysfunction (LTBD) is a significant concern for survivors of chronic critical illness (CCI).
- Understanding risk factors for LTBD is crucial for clinical practice and patient/family planning.
- Previous research has not extensively explored these factors.
Purpose of the Study:
- To identify risk factors associated with LTBD in CCI survivors.
- To investigate the link between acute delirium/coma during hospitalization and subsequent LTBD.
Main Methods:
- Prospective cohort study involving adult patients treated in a respiratory care unit for CCI.
- Utilized Confusion Assessment Method for ICU and Richmond Agitation and Sedation Scale to assess delirium and coma.
- Assessed survivors at 6 months post-discharge using the telephone Confusion Assessment Method.
Main Results:
- Over half (56.1%) of the 385 CCI patients died within 6 months.
- Among survivors, 64.7% experienced LTBD.
- Older age, higher Acute Physiology Score, multiple complications, and acute brain dysfunction during treatment were associated with increased LTBD risk.
Conclusions:
- LTBD is a prevalent outcome following treatment for CCI.
- Acute brain dysfunction during hospitalization is a significant predictor of LTBD.
- Older patient age and greater illness severity are also linked to higher LTBD rates.
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