The Present Status And Influencing Factors Of Post-intensive Care Syndrome In Adult After Cardiac Surgery

ObjectivesTo describe the incidence and related factors of Post-intensive care syndrome(PICS)for Patients after cardiac surgery.MethodsA cross-sectional descriptive study was designed.276 patients from two intensive care units for postoperative treatment after cardiac surgery in tertiary 1st class general hospitals(from April to September,2017)were surveyed by questionnaire on the Principle of convenience sampling.The questionnaires were collected in the third month follow-up after discharge.The evaluation of PICS was analyzed through mainly three aspects including cognitive,psychiatric and physical.The Mini-Mental State Examination(MMSE)for cognitive disability,Hospital Anxiety And Depression Scale(HADS)and The Impact of Event Scale(IES)for psychiatric disability,and Pittsburg Sleep Quality Index(PSQI)?Fatigue Assessment Instrument(FAI)and Barthel for physical disability,respectively.The affecting factors of PICS were measured by researcher-created Questionnaire on Patients' General Information and Questionnaire on Disease-Related Information.ResultsA total of 305 questionnaires were distributed and 276 complete ones were returned,with a response rate of 90.5%.The details were decribed as follows:1.Cognitive disability,Among 276 patients,the incidence of cognitive impairment was 52%,composed by mild cognitive impairment for 43%and moderate cognitive impairment for 9%.2.Mental disorder.These patients presented different symtoms of mental disorder,including anxiety(41%),depressive(43%)and Posttraumatic stress disorder(PTSD).3.Physical disability.66%patients experenced sleep disorder.More patients complained different levels of fatigue symptoms(69%)had impared quality of daily life(85%).4.The major risk factors of delirium following:age,education,complications,noninvasive,glucose dysregulation,prolonged mechanical ventilation,operation time(P<0.05).5.Affecting factors of postoperative cognitive dysfunction were including age,year of education,noninvasive,mechanical ventilation time,operation time,glucose dysregulation and ICU delirium.6.In terms of mental disorders,the age group(50-70 year old)got a higher score in anxiety and depression.People with lower education presented more significant symptoms in anxiety,depression and PTSD.Ones with complications and glucose dysregulation were susceptible to depression disorders.Time of mechanical ventilation and operation,and noninvasive treatment were affecting factors of HADS and PTSD(P<0.05).7.In Physiological disorders,Barthel index of elderly patients were lower.The fatigue scale score of junior high school education group was higher.Different marital status got varied score of Barthel index.People with Noninvasive got a higher PSQI.Ones with prolong mechanical ventilation time and operation time had a higher score in Barthel index,fatigue and PSQI.Glucose dysregulation got a lower Barthel index(P<0.05).8.The main outcomes of the correlation analysis are following:the score of HADS,IES and PSQI positively associated with ICU stay,and score of MMSE and Barthel index negatively associated with ICU stay.IES,PSQI and fatigue negatively associated with MMSE.Depression,IES,PSQI and fatigue positively associated with anxiety.IES,PSQI and fatigue positively associated with depression.PSQI and fatigue positively associated with IES.PSQI positively associated with fatigue.Conclusions1.The incident rates of Post-intensive care syndrome in adult after cardiac surgery was high,which manifested in cognitive,psychiatric and physical disability,2.The different was remarkable for patients suffering from delirium in comparative group such as age,education,complications,noninvasive ventilation therapy,glucose dysregulation,prolonged mechanical ventilation and operation time(P<0.05).3.The risk factors of PICS include older age,lower education level,noninvasive ventilation,prolonged mechanical ventilation,operation time,glucose dysregulation,preexisting disability,and the use of sedation and analgesia.In addition,delirium can cause cognitive impairment,and the incidence of depression in patients with complications is also higher.