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[Analysis of the risk factors of cognitive impairment in post-intensive care syndrome patient].

OBJECTIVE: To investigate the risk factors of cognitive impairment in post-intensive care syndrome patient (PICS-CI).

METHODS: A retrospective study was conducted. The patient who transferred from post-intensive care unit (ICU) to the general ward for more than 7 days, and with the age ≥ 18 years old in the First Affiliated Hospital of Jinzhou Medical University from October 2015 to November 2016 were enrolled. The gender, age, marital status, education, occupation, salary, economic income, smoking, alcohol drinking, previous of history, mechanical ventilation, the length of ICU stay, sedative and delirium, and initial diagnosis were recorded. According to mini-mental state examination (MMSE), the patients were divided into cognitive impairment (CI) group and non-CI group. Univariate analysis was performed to identify the risk factors of PICS-CI, and variables with statistical difference were selected to do multivariate binary logistic regression analysis for the confirmable independence risk factors.

RESULTS: 104 of the 290 patients developed CI, and the incidence was 35.86%. Univariate analysis showed that the gender, age, education, financial situation, smoking, alcohol drinking, previous of history, mechanical ventilation, the length of ICU stay, sedative and delirium, and initial diagnosis were recorded of ICU were main predictors of PICS-CI patients. It was shown by multivariate binary logistic regression analysis that the age > 60 years old [odds ratio (OR) = 7.523, 95% confidence interval (95%CI) = 2.572-37.851, P = 0.001], mechanical ventilation (OR = 8.773, 95%CI = 2.588-36.344, P < 0.001), sedation (OR = 9.376, 95%CI = 2.661-42.011, P = 0.002), and delirium (OR = 13.201, 95%CI = 2.502-41.433, P < 0.001) were PICS-CI independence risk factors.

CONCLUSIONS: Nurse staffs should strength care and attention on ICU transferred out patients. In order to minimize PICS impairment, special precaution should be implemented according to different aspects.

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