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Incidence and Risk Factors for Intensive Care Unit–related Post-traumatic Stress Disorder in Veterans and Civilians
Mayur B. Patel, James C. Jackson, Alessandro Morandi, Timothy D. Girard, Christopher G. Hughes,Jennifer L. Thompson, Amy L. Kiehl, MarkR.Elstad, Mitzi L. Wasserstein, Richard B. Goodman,Jean C. Beckham, Rameela Chandrasekhar, RobertS.Dittus, E. Wesley Ely, and Pratik P. Pandharipande
American Journal of Respiratory and Critical Care Medicine
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Critical Care Physicians
Rationale:The incidence and risk factors of post-traumatic stress disorder (PTSD) related to the intensive care unit (ICU) experience have not been reported in a mixed veteran and civilian cohort.
Objectives:To describe the incidence and risk factors for ICU-related PTSD in veterans and civilians.
Methods:This is a prospective, observational, multicenter cohort enrolling adult survivors of critical illness after respiratory failure and/or shock from three Veterans Affairs and one civilian hospital. After classifying those with/without preexisting PTSD (i.e., PTSD before hospitalization), we then assessed all subjects for ICU-related PTSD at 3 and 12 months post hospitalization.
Measurements and Main Results:Of 255 survivors, 181 and160 subjects were assessed for ICU-related PTSD at 3- and 12-monthfollow-up, respectively. A high probability of ICU-related PTSD was found in up to 10% of patients at either follow-up time point, whether assessed by PTSD Checklist Event-Specific Version (score>50) or item mapping using the Diagnostic and Statistical Manual of Mental Disorders-IV(DSM-IV). In the multivariable regression, pre-existingPTSD was independently associated with ICU-related PTSD at both3and12months(P,0.001), as was preexisting depression(P,0.03), but veteran status was not a consistent independent risk factor for ICU-related PTSD (3-monthP= 0.01, 12-monthP= 0.48).
Conclusions:This study found around 1 in 10 ICU survivors experienced ICU-related PTSD (i.e., PTSD anchored to their critical illness) in the year after hospitalization. Preexisting PTSD and depression were strongly associated with ICU-related PTSD.
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