(286) Post-Intensive Care Syndrome Trajectory Over 12 Months in Acute Respiratory Failure Survivors

Monday, January 22, 2024

11:30 AM – 12:30 PM MT

Location: Connections Central - RST 13

First Author(s)

Parth Savsani, MD, (he/him/his)

Indiana University School of Medicine

Co-Author(s)

SM

Salwa Moiz, n/a

Research Specialist
Regenstrief Institute, Indiana University School of Medicine, Indianapolis, IN, USA
Indianapolis, Indiana, United States
Samreen Jawaid, MD, (she/her/hers)

MD
Indiana University
RC

Rosalyn Chi, MD

Pulmonary and Critical care Fellow Physician
Indiana University, United States
AP

Anthony Perkins, MS

Biostatistician
Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
Indianapolis, Indiana, United States
SK

Sikandar Khan, DO, MS

Assistant Professor of Medicine/Physician Scientist
Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
Indianapolis, Indiana, United States
SG

Sujuan Gao, PhD

Professor of Biostatistics & Health Data Science
Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
Indianapolis, Indiana, United States
BK

Babar Khan, MD

Professor of Medicine/Physician Scientist
Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
Indianapolis, Indiana, United States

Introduction: Post-Intensive Care Syndrome (PICS) is highly prevalent in acute respiratory failure (ARF) survivors. We measured the burden of cognitive, physical, and mental health symptoms in ARF survivors longitudinally, based on the hypothesis that ARF survivors would report persistent, multi-domain PICS symptoms at 12-months post ICU discharge.

Methods: We conducted a secondary data analysis among ARF survivors enrolled in a clinical trial. English speaking, ARF patients who were 18 years or older were included. Patients with severe neurodegenerative/psychiatric conditions or life expectancy < 1 year were excluded. The validated 27-item Healthy Aging Brain Care Monitor Self Report (HABC-M SR) tool was administered at 1 week, and 3- and 12-months to evaluate cognitive, functional, and mood symptoms of PICS (range of scores, overall: 0-81, subscales: 0-18, 0-33, 0-30 respectively; normal overall: ≤14, subscales: ≤4, ≤3, ≤5 respectively; severe overall: ≥36, subscales: ≥12). We performed mixed effects models with random effects for patient and log transformation to assess change in HABC-M scores for time.

Results: We included 233 patients in the analysis with mean age of 55.2 years (SD: 14.3), 53.6% were female, and 40.3% Black. Median APACHE II score was 24 (IQR 18-31), median mechanical ventilation duration of 68.8 hours (IQR: 40-134.9), and median ICU stay of 9 days (IQR: 5-14). Mean HABC-M SR scores decreased significantly from baseline (8.64 SD: 7.8) to 3 months (5.30; SD: 6.81) and 12 months (4.83; SD: 6.79), p< 0.001. No significant differences were observed between 3- and 12-months scores. HABC-M subscales showed similar trends: cognitive - baseline (1.11; SD: 1.74), 3 months (0.67; SD: 1.64), 12 months (0.59; SD: 1.41), p< 0.040; functional - baseline (3; SD: 3.81), 3 months (1.48; SD: 2.62), 12 months (1.51; SD: 2.27), p< 0.001; and mood - baseline (4.53; SD: 4.31), 3 months (3.16; SD: 4.01), 12 months (2.72; SD: 3.97), p< 0.004.

Conclusions: ARF survivors reported mild PICS symptoms in each domain with significant improvement from discharge to 3 months. Correlation with repeated cognitive, physical function, and psychiatric assessments may be needed to further delineate long-term outcomes.