title: Long-term cognitive outcomes among unselected ventilated and non-ventilated ICU patients.
abstract: BACKGROUND
  Cognitive dysfunction is an important long-term complication of critical illness associated with reduced quality of life, increase in healthcare costs, and institutionalization. Delirium, an acute form of brain dysfunction that is common during critical illness has been shown to be associated with long-term cognitive dysfunction. The aim of this prospective cohort study was to estimate the prevalence and severity of cognitive dysfunction in an unselected population of medical and surgical ICU patients.
  
  
  METHODS
  This prospective observational cohort study included all adult patients admitted to the surgical (13 beds) and medical (32 beds) ICUs of a tertiary hospital over a 12-month period. Patients with impaired cognition were excluded. At least 3 months after hospital discharge, patients were assessed for cognition using a validated battery of tests and were classified as having no cognitive impairment, mild to moderate cognitive impairment, or severe cognitive impairment.
  
  
  RESULTS
  Four hundred thirteen patients were tested an average of 11 (3-18) months after discharge. Fifty-five (13.3%) patients included in the follow-up cohort had delirium. Cognitive impairment was identified in 206 (49.9%) patients, 120 (29.1%) patients had mild or moderate cognitive impairment, and 86 (20%) patients had severe cognitive dysfunction.
  
  
  CONCLUSIONS
  This investigation in an unselected and lower severity population of critically ill patients demonstrates that cognitive dysfunction is a frequent and severe long-term complication.
authors.affiliation: Intensive Care Unit, Hospital São Domingos, Av. Jerônimo de Albuquerque, 540, Bequimao, São Luis, MA 65060-645 Brazil.
authors.forename: José Raimundo A
authors.initials: JR
authors.lastname: de Azevedo
authors.affiliation: Intensive Care Unit, Hospital São Domingos, Av. Jerônimo de Albuquerque, 540, Bequimao, São Luis, MA 65060-645 Brazil.
authors.forename: Widlani Sousa
authors.initials: WS
authors.lastname: Montenegro
authors.affiliation: Intensive Care Unit, Hospital São Domingos, Av. Jerônimo de Albuquerque, 540, Bequimao, São Luis, MA 65060-645 Brazil.
authors.forename: Djane Pereira
authors.initials: DP
authors.lastname: Rodrigues
authors.affiliation: Intensive Care Unit, Hospital São Domingos, Av. Jerônimo de Albuquerque, 540, Bequimao, São Luis, MA 65060-645 Brazil.
authors.forename: Suellen C
authors.initials: SC
authors.lastname: de C Souza
authors.affiliation: Intensive Care Unit, Hospital São Domingos, Av. Jerônimo de Albuquerque, 540, Bequimao, São Luis, MA 65060-645 Brazil.
authors.forename: Vanessa F S
authors.initials: VF
authors.lastname: Araujo
authors.affiliation: Intensive Care Unit, Hospital São Domingos, Av. Jerônimo de Albuquerque, 540, Bequimao, São Luis, MA 65060-645 Brazil.
authors.forename: Margareth Pereira
authors.initials: MP
authors.lastname: de Paula
authors.affiliation: Intensive Care Unit, Hospital São Domingos, Av. Jerônimo de Albuquerque, 540, Bequimao, São Luis, MA 65060-645 Brazil.
authors.forename: Patricia H C P
authors.initials: PH
authors.lastname: Prazeres
authors.affiliation: Intensive Care Unit, Hospital São Domingos, Av. Jerônimo de Albuquerque, 540, Bequimao, São Luis, MA 65060-645 Brazil.
authors.forename: Adenilde
authors.initials: A
authors.lastname: da Luz Leitão
authors.affiliation: Intensive Care Unit, Hospital São Domingos, Av. Jerônimo de Albuquerque, 540, Bequimao, São Luis, MA 65060-645 Brazil.
authors.forename: Adriana V N
authors.initials: AV
authors.lastname: Mendonça
keywords: Cognitive dysfunction; Critical illness; Delirium; Follow-up; Intensive care unit; Outcome