Article

OBJECTIVES: To determine whether delirium during the hospital stay predicted
health-related quality of life (HRQOL) at 1 year after injury in trauma intensive
care unit (ICU) survivors without intracranial hemorrhage, and to examine the
association between depressive and posttraumatic stress disorder (PTSD) symptoms
and each of the HRQOL domains at 1-year follow-up. DESIGN: Prognostic cohort with
a 1-year follow-up. SETTING: Level 1 trauma ICU. PARTICIPANTS: Adult patients
without intracranial hemorrhage (N=173) admitted to a level 1 trauma ICU.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: HRQOL was measured with the
Medical Outcomes Study 36-Item Short-Form Health Survey at 1 year after traumatic
injury. RESULTS: Average delirium duration +/- SD was .51+/-1.1 days.
Hierarchical multivariable linear regression analyses did not find a statistical
relationship between delirium and HRQOL at 1-year follow-up. However, increased
levels of depressive symptoms at 1 year were statistically associated with poorer
functioning in all physical and mental health HRQOL domains, whereas PTSD at 1
year was statistically associated with all HRQOL domains except role-physical
(P<.05). CONCLUSIONS: There was no statistical association between delirium
during the hospital stay and HRQOL at 1 year, which may be due to the short time
spent in delirium by our study population. Depressive symptoms demonstrated a
stronger relationship with mental and physical HRQOL domains at 1 year than PTSD,
indicating their own unique pathway after trauma. Findings lend support for the
separate assessment and management of depression and PTSD. Additional research on
the duration and subtypes of delirium is needed within the trauma ICU population,
as the effects are not widely known.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS