title: Significant cognitive dysfunction in non-delirious patients identified during and persisting following critical illness.
abstract: OBJECTIVE
  Recent studies have shown significant cognitive problems some months after critical illness. However there has been no research examining cognitive function within the intensive care unit (ICU) in non-delirious patients.
  
  
  METHODS
  A prospective study in an ICU.
  
  
  METHODS
  Using the Cambridge Neuropsychological Test Automated Battery (CANTAB), 30 long-stay, tracheal-intubated ICU patients were tested. Prior to testing on ICU the Confusion Assessment Measure (CAM-ICU) was administered and only those patients clearly not delirious and off sedation for several days were tested. The CANTAB tests were repeated a week after ICU discharge on the general ward and then again at 2 months. Sixteen patients completed the follow-up.
  
  
  RESULTS
  While on ICU all 30 patients showed significant problems with strategic thinking and problem solving; 20 patients had some problems with memory. The degree of difficulty with problem solving on ICU was correlated with length of ICU stay (p=0.011), age (p=0.036) and length of hospital stay post ICU (p=0.044). Problems with memory in ICU and on the general ward were correlated with admission APACHE II score (p=0.004 and p=0.005 respectively). At the 2-month follow-up 5 of 16 patients (31%) scored below the 25 percentile for memory and 8 of 16 (50%) below the 25 percentile for problem solving (Slater TA, Jones C, Griffiths RD, Wilson S, Benjamin K (2004) Cognitive impairment during and after intensive care: a pilot study. Intensive Care Med 30 [Suppl 1]:S199).
  
  
  CONCLUSIONS
  Difficulties with problem solving and poor memory remained a significant issue for 2 months after ICU discharge.
authors.affiliation: Whiston Hospital, Intensive Care Unit, L35 5DR, Prescot, UK. christinajonesc@aol.com
authors.forename: Christina
authors.initials: C
authors.lastname: Jones
authors.forename: Richard D
authors.initials: RD
authors.lastname: Griffiths
authors.forename: Tracy
authors.initials: T
authors.lastname: Slater
authors.forename: Kirsten S
authors.initials: KS
authors.lastname: Benjamin
authors.forename: Sally
authors.initials: S
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis*; D016638:Critical Illness / Q000523:psychology*; D003693:Delirium; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006113:United Kingdom