The Incidence And Influencing Factors Of Post-ICU Cognitive Impairment

Objective:To investigate the incidence of post-ICU cognitive impairment and analyze its influencing factors and provide evidence to build targeted clinical interventions to improve ICU patients’ cognition level.Method:According to inclusion and exclusion criteria,critically ill patients who were admitted to a general ICU of a tertiary hospital in Lanzhou from August 2018 to November 2019 were selected as the research population.Relevant demographic sociological data and clinical data were collected during the ICU hospitalization.Richards-Campbell Sleep Questionnaire(RCSQ)scale was used to assess ICU patients’ sleep status in ICU within 3 days after they were transferred out of the ICU during the hospitalization period.The patient’s cognitive function was evaluated on the day of discharging by Montreal Cognitive Assessment(MoCA)scale.EpiData 3.1 and SPSS 21.0 were used for data entry and statistical analysis respectively.Rank sum tests and χ2 tests were used for univariate analysis of the relevant factors.23 influencing factors with statistical differences(P <0.05)were used as independent variables,and post-ICU cognitive impairment was used as the dependent variable.After reassignment,multivariable Logistic regression analysis was carried out.Result:(1)A total of 1,536 patients were screened in this study,431 patients reached the inclusion criteria,22 patients fell off,and 409 patients were successfully investigated.There were 185 patients with post-ICU cognitive impairment.The incidence of postICU cognitive impairment was 45.2%(185/409).(2)Single analysis results showed that age,years of education,occupation,past medical history,main ICU diagnosis,Acute Physiology and Chronic Evaluation Scoring System(APACHE II)score,Sequential Organ Failure Assessment(SOFA)score,charlson comorbidity index,ICU length-of-stay(LOS),total hospital LOS,sedation,vasoactive agents,muscle relaxants,mechanical ventilation and duration of mechanical ventilation,constraints,early active mobilization,hypoxemia,frequency and severity of delirium,blood pressure,rescue experience,and infection were related to post-ICU cognitive impairment(P <0.05).(3)Multivariate analysis results showed that the frequency and severity of delirium,and advanced age were risk factors of post-ICU cognitive impairment;high years of education and early active mobilization were protective factors.Conclusion:Incidence of post-ICU cognitive impairment is at a high level,which is similar to former researches’ results;the frequency and severity of delirium,and advanced age were risk factors of post-ICU cognitive impairment;high years of education and early active mobilization were protective factors of post-ICU cognitive impairment.