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One-quarter of ICU patients with critical illness develop PTSD

Results from a systematic literature review indicate that nearly one-quarter of patients who stay in the ICU following critical illness develop PTSD and that keeping diaries while in the unit may be a preventative tool.

Researchers from Johns Hopkins University School of Medicine assessed 40 studies with a combined cohort of more than 3,000 patients who survived a critical illness and stayed in the ICU. Patients who experienced traumatic events or brain injury were excluded from analysis because their cognitive outcomes may have been affected by those events rather than the critical illness or ICU stay.

Overall, PTSD prevalence ranged from 10% to 60% across study cohorts.

To more definitively assess PTSD prevalence, researchers analyzed a subset of six studies with a combined cohort of 450 patients. This analysis indicated one out of four patients who stayed in the ICU following critical illness experienced PTSD symptoms.

When assessing patients 7 to 12 months after ICU stay, researchers found that one out of five patients had PTSD.

“These rates are as high as you might see in combat soldiers or rape victims,” study researcher Dale Needham, MD, professor of medicine and of physical medicine and rehabilitation at Johns Hopkins, said in a press release. “Our clinicians and patients should know that the high risk of PTSD exists among patients surviving critical illness.”

Keeping a “diary,” or a notebook with daily messages from clinicians and family members about what is happening to the patient was significantly effective in preventing PTSD among patients in the ICU, according to researchers.

“Diaries seem to help patients process their experience and formulate more accurate memories of their time in the ICU. They provide patients with a tool to better understand their experience in the ICU through the words of their loved ones and caregivers,” study researcher Joe Bienvenu, MD, associate professor of psychiatry at Johns Hopkins, said in the release.

As a result of the study findings, clinicians within the ICU at Johns Hopkins Hospital are implementing a quality improvement project that includes using an ICU diary as a tool to prevent PTSD and improve recovery, according to the release.

“To ensure that these patients have the best possible quality of life, we have to look at what their lives are like after they leave the ICU,” Needham said. – by Amanda Oldt

Disclosure: Healio.com/Psychiatry was unable to confirm relevant financial disclosures at the time of publication.