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.