Risk factors of long-term brain health outcomes after hospitalization for critical illness.

Autor: Peinkhofer C; Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 8, 2100, Copenhagen, Denmark., Grønkjær CS; Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Bispebjerg Bakke 23, NV 2400, Copenhagen, Denmark., Bang LE; Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Fonsmark L; Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Jensen JS; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Department of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark., Katzenstein TL; Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Kjaergaard J; Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Lebech A; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Merie C; Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Nersesjan V; Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Bispebjerg Bakke 23, NV 2400, Copenhagen, Denmark., Sivapalan P; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Department of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark., Zarifkar P; Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 8, 2100, Copenhagen, Denmark., Benros ME; Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Bispebjerg Bakke 23, NV 2400, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Kondziella D; Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 8, 2100, Copenhagen, Denmark. daniel.kondziella@regionh.dk.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. daniel.kondziella@regionh.dk.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2024 Dec 16; Vol. 272 (1), pp. 71. Date of Electronic Publication: 2024 Dec 16.
DOI: 10.1007/s00415-024-12786-3
Abstrakt: Background: Brain health may be impaired years after hospitalization for critical illness, and similar impairments occur after hospitalization for COVID-19. However, it remains unclear which patients are most likely to experience long-term brain health consequences and whether these adverse events differ between non-COVID critical illness and COVID-19.
Methods: In a prospective observational study, we enrolled patients hospitalized for (1) non-COVID critical illness (pneumonia, myocardial infarction, or ICU-requiring conditions) or for (2) COVID-19, from March 2020 to June 2021. Brain health was assessed at 18-month follow-up with cognitive, psychiatric, and neurological tests. We used both logistic regression and prediction models to test for associations between different variables and brain health.
Results: We included 245 patients: 125 hospitalized for non-COVID critical illness and 120 for COVID-19 [mean age 61.2 (± 13.6) years, 42% women]. Brain health was impaired in 76% of patients (72% critical illness, 81% COVID-19; p = 0.14) at 18-month follow-up. The strongest predictive factors associated with impaired brain health were education < 13 years, age ≥ 70 years, and neuroticism traits in the best performing model (AUC = 0.63). When analyzing non-COVID critical illness and COVID-19 patients separately, low education was one of the few factors associated with impaired brain health in both groups (AUCs for best models: 0.66 and 0.69).
Conclusion: Brain health is comparably impaired after hospitalization for critical illness and COVID-19. Factors like higher age, lower education and neuroticism may help identifying vulnerable individuals, who could benefit from close monitoring to improve brain health after critical illness, regardless of the underlying disease etiology.
Competing Interests: Declarations. Conflicts of interest: The authors have no relevant conflicts of interest related to the content of this study. Ethical standard: The study was approved by the Danish Regional Committee on Health Research Ethics in Copenhagen (H-20026602). Written consent was obtained from all participants. All procedures were done according to the Declaration of Helsinki.
(© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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