Neurocognitive Outcomes After Critical Illness: Post-ICU Syndrome in Sepsis Survivors

To measure neurocognitive abilities, psychological well-being, and quality of life (QOL) in survivors of adult sepsis post-intensive care unit (ICU) discharge in Pakistan and to establish clinical and demographic predictors of post-ICU outcomes.

A cross-sectional study at tertiary care hospitals in Islamabad, Pakistan.

Structured questionnaires were used to evaluate 500 adult survivors of sepsis, 4-8 weeks after ICU discharge. Mini-Mental State Examination (MMSE) was used to measure cognitive functioning, Hospital Anxiety and Depression Scale (HADS) to measure psychological symptoms, and the Short Form-36 (SF-36) to measure QOL. Hospital records provided demographic and clinical information. Statistical procedures involved chi-square tests, Mann-Whitney U tests, Kruskal-Wallis tests, Spearman correlations, and multiple regression tests.

Among 500 participants, 284 (57%) were cognitively impaired (MMSE < 24), 300 (60%) reported borderline-to-clinical anxiety, and 250 (50%) were depressed. The QOL was low, with the mean SF-36 score being 35/100 (SD ± 12). The longer the ICU stay, the poorer the cognition, the more anxiety, and the lower the quality of life (p < 0.001). Poorer outcomes were also predicted by older age (> 60 years, n = 150; 30%) and female sex (n = 180; 36%).

In Pakistan, cognitive impairment, psychological distress, and poor quality of life among sepsis survivors are high within weeks of ICU discharge. Longer ICU stay, comorbidities, female sex, and older age predict poorer outcomes. Early follow-up and organised rehabilitation measures are acutely required to enhance survivorship.