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중환자실 퇴원환자의 인지장애 위험요인

Risk Factors for Cognitive Impairment in Intensive Care Unit Survivors

중환자간호학회지 2020년 13권 3호 p.75 ~ 85
강지연, 이보경,
소속 상세정보
강지연 ( Kang Ji-Yeon ) - Dong-A University Department of Nursing
이보경 ( Yi Bo-Kyung ) - Dong-A University Hospital Cardiovascular Intensive Care Unit

Abstract


Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU).

Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation.

Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65∼30.33, p <.001), education < high school graduation (OR=2.53, 95% CI=1.07∼6.01, p =.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p =.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p =.038).

Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions.

키워드

중환자실; 인지장애; 섬망; 환자; 위험요인
Intensive care unit; Cognitive dysfunction; Delirium; Patients; Risk factors

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