Outcome after injury: memories, health-related quality of life, anxiety, and symptoms of depression after intensive care.
BACKGROUND
To examine the relationship between delusional memories from the Intensive Care Unit (ICU) stay, health related quality of life (HRQoL), anxiety, and symptoms of depression in patients with physical trauma, 6 months to 18 months after their ICU stay.


METHODS
Multicenter study in five combined medical and surgical ICUs (n = 239). A questionnaire comprising the Medical outcome Short Form 36, the Hospital Anxiety and Depression scale, and the Intensive Care Unit Memory tool was sent to the patients with trauma 6 months to 18 months after their discharge from the ICU. Clinical data were drawn from patient records in retrospect. A matched reference sample (n = 159) was randomly drawn from the Swedish Short Form 36 norm database (n = 8,930).


RESULTS
Patients with trauma had significantly lower HRQoL than the reference sample. One or more delusional memories such as hallucinations, nightmares, dreams, or sensations of people trying to hurt them in the ICU were experienced by 26%. These patients were significantly younger, had a longer ICU stay, relied more on mechanical ventilation, and had higher Injury Severity Score and Sequential Organ Failure Assessment scores. They also reported a significantly poorer HRQoL and a higher probability of experiencing anxiety (51% vs. 29%) and symptoms of depression (48% vs. 26%) compared with patients without such memories.


CONCLUSIONS
Our results highlight the importance of treating the delusional memories experienced by ICU patients with a trauma diagnosis as a postinjury factor with a potential to create anxiety and symptoms of depression and which may affect HRQoL after discharge.
Ringdal
Mona
M
Institute of Health and Care Sciences, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden. mona.ringdal@fhs.gu.se
Plos
Kaety
K
Lundberg
Dag
D
Johansson
Lotta
L
Bergbom
Ingegerd
I
D018806:APACHE; D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D003422:Critical Care / Q000523:psychology*; D016638:Critical Illness / Q000523:psychology; D003702:Delusions / Q000523:psychology*; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008569:Memory Disorders / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life; D014947:Wounds and Injuries / Q000523:psychology* / Q000628:therapy