Are intensive care factors associated with depressive symptoms 6 months after acute lung injury?
OBJECTIVE
To evaluate intensive care-related factors as predictors of depressive symptoms 6 months after acute lung injury (ALI).


METHODS
Prospective cohort study.


METHODS
Thirteen intensive care units (ICUs) in four hospitals in Baltimore, MD.


METHODS
Consecutive ALI survivors (n = 160; 71% from medical ICUs) screened for depressive symptoms at 6 months post-ALI.


METHODS
None.


RESULTS
We prospectively measured 12 features of critical illness and ICU care and used multivariable regression to evaluate associations with depressive symptoms as measured by the Hospital Anxiety and Depression Score. The prevalence of a positive screening for depression (score > or = 8) at 6 months post-ALI was 26%. Depressive symptoms were significantly associated with surgical (vs. medical or trauma) ICU admission (relative risk [RR] 2.2, 95% confidence interval [CI] 1.1-4.2), maximum daily Sequential Organ Failure Assessment Score of >10 (RR 2.1, 95% CI 1.1-3.5), and mean daily ICU benzodiazepine dose of > or = 75 mg of midazolam equivalent (RR 2.1, 95% CI 1.1-3.5).


CONCLUSIONS
Depressive symptoms at 6 months post-ALI are common and potentially associated with ICU-related factors. Mechanisms by which critical illness and intensive care management associate with depressive symptoms merit further investigation.
Dowdy
David W
DW
School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Bienvenu
Oscar Joseph
OJ
Dinglas
Victor D
VD
Mendez-Tellez
Pedro A
PA
Sevransky
Jonathan
J
Shanholtz
Carl
C
Needham
Dale M
DM
D055371:Acute Lung Injury / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D003422:Critical Care / Q000379:methods / Q000523:psychology*; D003863:Depression / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D017678:Sex Distribution; D018434:Sickness Impact Profile; D017741:Survivors; D013997:Time Factors