Provider-Documented Anxiety in the ICU: Prevalence, Risk Factors, and Associated Patient Outcomes
| Autor: | Jennifer E. Jutte, Andrew D. May, Catherine L. Hough, Megan M. Hosey, Ellen Caldwell, Ann M. Parker, Mayra Sanchez Gonzalez, Dale M. Needham |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty business.industry Critically ill Delirium 030208 emergency & critical care medicine Anxiety Critical Care and Intensive Care Medicine Mental health Intensive Care Units 03 medical and health sciences 0302 clinical medicine Risk Factors Chart review Intensive care Emergency medicine Prevalence Humans Medicine 030212 general & internal medicine medicine.symptom business Retrospective Studies |
| Zdroj: | Journal of Intensive Care Medicine. 36:1424-1430 |
| ISSN: | 1525-1489 0885-0666 |
| DOI: | 10.1177/0885066620956564 |
| Popis: | Purpose: To determine the prevalence of provider-documented anxiety in critically ill patients, associated risk factors, and related patient outcomes. Method: Chart review of 100 randomly sampled, adult patients, with a length of stay ≥48 hours in a medical or trauma/surgical intensive care unit (ICU). Provider-documented anxiety was identified based on a comprehensive retrospective chart review of the ICU stay, searching for any acute episode of anxiety (e.g., documented words related to anxiety, panic, and/or distress). Results: Of 100 patients, 45% (95% confidence interval: 35%-55%) had documented anxiety, with similar prevalence in medical vs. trauma/surgical ICU. Patients with documented anxiety more frequently had history of anxiety (22% vs. 4%, p = .004) and substance abuse (40% vs. 22%, p = .048). In the ICU, they had greater severity of illness (median (IQR) Acute Physiology Score 16(13,21) vs. 13(8,19), p = .018), screened positive for delirium at least once during ICU stay, (62% vs. 31%, p = .002), benzodiazepines and antipsychotics use (87% vs. 58%, p = .002; 33% vs. 13%, p = .013, respectively), and mental health consultation (31% vs. 18%, p = .132). These patients also had longer ICU and hospital lengths of stay (6(4,11) vs. 4(3,6), pConclusions: Documented anxiety, occurring in almost half of ICU patients with length of stay ≥48 hours, was associated with a history of anxiety and/or substance abuse, and greater ICU severity of illness, delirium, psychiatric medications, and length of stay. Increased awareness along with more standardized protocols for assessment of anxiety in the ICU, as well as greater evaluation of non-pharmacological treatments for anxiety symptoms in the ICU are warranted. |
| Databáze: | OpenAIRE |
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