Post intesive care syndrome (PICS) evaluation

ICU stay is a traumatic and stressful event for both patients and family members. Patients usually suffer from a series of physical and psycho-emotional changes that may last after discharge, which is known as Post-Intensive Care Syndrome (PICS).

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The PICS is an entity, recently described, consisting of the physical, cognitive and psychological consequences that patients may suffer after discharge; these can become chronic and even develop a post-traumatic stress disorder. 

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According to the Society of Critical Care Medicine (SCCM) Critical Care Statistics in the United States, 2012, 3.5 million patients per year survive the Intensive Care Unit.

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The term of the Post-Intensive Care Unit Syndrome (PICS) was described and recommended by the SCCM from the year 2010 because some patients discharged from the ICU are trapped in a recurrent cycle of disease and re hospitalization. Only a percentage of them fully recovered.

Objectives of the PICS  Syndrome Evaluation

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The general objective of the study is:

•  Identify the users, who developed the PICS,  admitted to the Pasteur Hospital ICU from March 1 to May 31, 2017. ​

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The specific objectives are:

• Evaluate the incidence and prevalence of cognitive and emotional disorders that make up the PICS of the assisted patients.

• Determine the risk factors associated with the PICS development

• Study the relationship between delirium development and cognitive and emotional disorders that form the PICS.

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Methodology of the PICS evaluation

Population:

Patients discharged from the Pasteur Hospital ICU who were admitted in the period between 03/01/2017 and 05/31/2017 will be evaluated, with different pathologies and different severity scores (Apache II ).

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Period during which the incidence of delirium, the risk factors associated with it, the duration of ICU stay , hospital stay and mortality were determined (results of the For an ICU without delirium study)

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The work will be carried out in two stages:

First stage (data collection)

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A list of patients and their telephone numbers will be obtained through the computer system and review of medical records. Through telephone consultation, a first interview consisting of 10 questions will be conducted.

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The reason for the completion of the same will be explained and patients will be invited to participate in a second instance in person, where informed consent will be provided and new interviews will be conducted by different professionals: Intensive doctors, psychologists, psychiatrists, and registered nurses specialized in ICU where different evaluation scales will be appled.

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Second stage (Interpretation of data)

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Once the data from the interviews is obtained, it will be grouped into tables according to type of risk factors or disorders. The data of the bibliographic references will be compared and presented through graphs in order to obtain a graphic evaluation of the Pasteur Hospital population with PICS.

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The aspects related to the cognitive and mental sphere of the PICS will be evaluated through interviews where different scales will be used.

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These will be carried out by different professionals of the health team, with outstanding knowledge and performance in these areas, psychiatrist, psychologists, ICU physicians and registered nurses specialized in ICU where the scales will be applied.

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The instruments for the evaluation of PICS syndrome are:

Scales:

• Hamilton which evaluates ​​anxiety.

• De Beck 2, which evaluates ​​depression.

• Pfeiffer which evaluates cognitive impairment.

• Barthel which evaluates ​​physical disability for daily life activities,.

This work is being currently done.