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A 67-year-old man complains of memory loss, difficulty with finances, mood swings, anxiety, and generalized weakness after a recent ICU hospitalization. After reading the case, take the quiz.
A 67-year-old man complains of memory loss, difficulty with finances, mood swings, anxiety, and generalized weakness after a recent ICU hospitalization for COPD exacerbation requiring intubation and mechanical ventilation. A history is taken and a physical examination is performed with basic laboratory work. Which of the following statements is TRUE regarding his post-intensive care syndrome (PICS)?
Post-intensive care syndrome (PICS) is a rapidly growing phenomenon in older adults. As survival rates from ICU hospitalizations have increased over the past few decades, the long-term cognitive, psychological, and physical sequelae of the illness have become a major challenge in critical care medicine. More than half of all ICU survivors suffer from at least one PICS-related impairment, and these effects can persist as long as 5 or more years.
Depression, anxiety, and PTSD are the best-characterized mental health impairments in PICS. Among adult ICU survivors, the prevalence of depression is 19% to 37%6; the prevalence of anxiety is 32% to 40%7; and the prevalence of PTSD is 19% to 22%.8 Psychiatric comorbidity in ICU survivors is 4 to 6 times more common than in the general population (25% to 33% of ICU survivors versus 6% for the general population).
For more on this topic, see Post-Intensive Care Syndrome: Recognizing the Critical Need for Psychiatric Care, on which this quiz is based.