Frequency and spectrum of Post-Intensive Care Syndrome (PICS) in survivors of critical illness in a tertiary care hospital in Pakistan.

Abstract

Objective: To determine the frequency and spectrum of post-intensive care syndrome (PICS) in survivors of critical illness at a tertiary care hospital of Pakistan. Study Design: Cross-sectional study. Setting: Intensive Care Unit (ICU) of the Sindh Institute of Urology and Transplantation, Karachi, Pakistan. Period: November 2022 to July 2023. Methods: Critical illness survivors aged 18-75 years and discharged from intensive care units ICUs were analyzed. PICS was defined as new or worsening problem(s) in physical, cognitive, or mental health status arising after critical illness and persisting beyond acute care hospitalization. Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Clinical Frailty Scale (CFS) were used to evaluate cognitive, psychiatric, and physical impairments. Results: There were 91 patients, with a median age of 40 years (IQR = 23 - 48). Physical impairment was observed in 49.4% of patients, whereas cognitive impairment was found in 67%, and psychiatric impairment (based on PHQ-9 scores of 5 or greater and GAD-7 scores of 5 or greater) was observed in 49.4% and 45.0% of patients, respectively. Overall, the frequency of PICS was found to be 84.6% in our study, and the frequency of patients with impairment in 1, 2, or 3 domains was 33%, 14.3%, and 37.4%, respectively. Conclusion: PICS is a highly prevalent syndrome in survivors of critical illness. Shock is a statistically significant risk factor for PICS. Cognitive impairment appears to be the most common domain of PICS.