Hospital Delirium and Psychological Distress at 1 Year and Health-Related Quality of Life After Moderate-to-Severe Traumatic Injury Without Intracranial Hemorrhage
Abstract Objectives To determine whether delirium during the hospital stay predicted health-related quality of life (HRQOL) at 1 year after injury in trauma intensive care unit (ICU) survivors without intracranial hemorrhage, and to examine the association between depressive and posttraumatic stress...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2014-12, Vol.95 (12), p.2382-2389 |
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| container_title | Archives of physical medicine and rehabilitation |
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| creator | Abraham, Christine M., MA Obremskey, William T., MD, MPH Song, Yanna, MS Jackson, James C., PsyD Ely, E. Wesley, MD, MPH Archer, Kristin R., PhD, DPT |
| description | Abstract Objectives To determine whether delirium during the hospital stay predicted health-related quality of life (HRQOL) at 1 year after injury in trauma intensive care unit (ICU) survivors without intracranial hemorrhage, and to examine the association between depressive and posttraumatic stress disorder (PTSD) symptoms and each of the HRQOL domains at 1-year follow-up. Design Prognostic cohort with a 1-year follow-up. Setting Level 1 trauma ICU. Participants Adult patients without intracranial hemorrhage (N=173) admitted to a level 1 trauma ICU. Interventions Not applicable. Main Outcome Measures HRQOL was measured with the Medical Outcomes Study 36-Item Short-Form Health Survey at 1 year after traumatic injury. Results Average delirium duration ± SD was .51±1.1 days. Hierarchical multivariable linear regression analyses did not find a statistical relationship between delirium and HRQOL at 1-year follow-up. However, increased levels of depressive symptoms at 1 year were statistically associated with poorer functioning in all physical and mental health HRQOL domains, whereas PTSD at 1 year was statistically associated with all HRQOL domains except role-physical ( P |
| doi_str_mv | 10.1016/j.apmr.2014.08.005 |
| format | Article |
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Wesley, MD, MPH ; Archer, Kristin R., PhD, DPT</creator><creatorcontrib>Abraham, Christine M., MA ; Obremskey, William T., MD, MPH ; Song, Yanna, MS ; Jackson, James C., PsyD ; Ely, E. Wesley, MD, MPH ; Archer, Kristin R., PhD, DPT</creatorcontrib><description>Abstract Objectives To determine whether delirium during the hospital stay predicted health-related quality of life (HRQOL) at 1 year after injury in trauma intensive care unit (ICU) survivors without intracranial hemorrhage, and to examine the association between depressive and posttraumatic stress disorder (PTSD) symptoms and each of the HRQOL domains at 1-year follow-up. Design Prognostic cohort with a 1-year follow-up. Setting Level 1 trauma ICU. Participants Adult patients without intracranial hemorrhage (N=173) admitted to a level 1 trauma ICU. Interventions Not applicable. Main Outcome Measures HRQOL was measured with the Medical Outcomes Study 36-Item Short-Form Health Survey at 1 year after traumatic injury. Results Average delirium duration ± SD was .51±1.1 days. Hierarchical multivariable linear regression analyses did not find a statistical relationship between delirium and HRQOL at 1-year follow-up. However, increased levels of depressive symptoms at 1 year were statistically associated with poorer functioning in all physical and mental health HRQOL domains, whereas PTSD at 1 year was statistically associated with all HRQOL domains except role-physical ( P <.05). Conclusions There was no statistical association between delirium during the hospital stay and HRQOL at 1 year, which may be due to the short time spent in delirium by our study population. Depressive symptoms demonstrated a stronger relationship with mental and physical HRQOL domains at 1 year than PTSD, indicating their own unique pathway after trauma. Findings lend support for the separate assessment and management of depression and PTSD. Additional research on the duration and subtypes of delirium is needed within the trauma ICU population, as the effects are not widely known.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2014.08.005</identifier><identifier>PMID: 25175161</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Delirium ; Delirium - psychology ; Depression ; Depression - epidemiology ; Depression - psychology ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Multiple trauma ; Physical Medicine and Rehabilitation ; Psychiatric Status Rating Scales ; Quality of life ; Quality of Life - psychology ; Rehabilitation ; Stress disorders, post-traumatic ; Stress Disorders, Post-Traumatic - epidemiology ; Stress Disorders, Post-Traumatic - psychology ; Time Factors ; Trauma Severity Indices ; Wounds and Injuries - psychology</subject><ispartof>Archives of physical medicine and rehabilitation, 2014-12, Vol.95 (12), p.2382-2389</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2014 American Congress of Rehabilitation Medicine</rights><rights>Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-1dae6dc1f4a469da12c68ac6ad417b3ae86334fabd874006fd191e196442e9d23</citedby><cites>FETCH-LOGICAL-c411t-1dae6dc1f4a469da12c68ac6ad417b3ae86334fabd874006fd191e196442e9d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.apmr.2014.08.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25175161$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abraham, Christine M., MA</creatorcontrib><creatorcontrib>Obremskey, William T., MD, MPH</creatorcontrib><creatorcontrib>Song, Yanna, MS</creatorcontrib><creatorcontrib>Jackson, James C., PsyD</creatorcontrib><creatorcontrib>Ely, E. Wesley, MD, MPH</creatorcontrib><creatorcontrib>Archer, Kristin R., PhD, DPT</creatorcontrib><title>Hospital Delirium and Psychological Distress at 1 Year and Health-Related Quality of Life After Moderate-to-Severe Traumatic Injury Without Intracranial Hemorrhage</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Abstract Objectives To determine whether delirium during the hospital stay predicted health-related quality of life (HRQOL) at 1 year after injury in trauma intensive care unit (ICU) survivors without intracranial hemorrhage, and to examine the association between depressive and posttraumatic stress disorder (PTSD) symptoms and each of the HRQOL domains at 1-year follow-up. Design Prognostic cohort with a 1-year follow-up. Setting Level 1 trauma ICU. Participants Adult patients without intracranial hemorrhage (N=173) admitted to a level 1 trauma ICU. Interventions Not applicable. Main Outcome Measures HRQOL was measured with the Medical Outcomes Study 36-Item Short-Form Health Survey at 1 year after traumatic injury. Results Average delirium duration ± SD was .51±1.1 days. Hierarchical multivariable linear regression analyses did not find a statistical relationship between delirium and HRQOL at 1-year follow-up. However, increased levels of depressive symptoms at 1 year were statistically associated with poorer functioning in all physical and mental health HRQOL domains, whereas PTSD at 1 year was statistically associated with all HRQOL domains except role-physical ( P <.05). Conclusions There was no statistical association between delirium during the hospital stay and HRQOL at 1 year, which may be due to the short time spent in delirium by our study population. Depressive symptoms demonstrated a stronger relationship with mental and physical HRQOL domains at 1 year than PTSD, indicating their own unique pathway after trauma. Findings lend support for the separate assessment and management of depression and PTSD. Additional research on the duration and subtypes of delirium is needed within the trauma ICU population, as the effects are not widely known.</description><subject>Adult</subject><subject>Delirium</subject><subject>Delirium - psychology</subject><subject>Depression</subject><subject>Depression - epidemiology</subject><subject>Depression - psychology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multiple trauma</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Psychiatric Status Rating Scales</subject><subject>Quality of life</subject><subject>Quality of Life - psychology</subject><subject>Rehabilitation</subject><subject>Stress disorders, post-traumatic</subject><subject>Stress Disorders, Post-Traumatic - epidemiology</subject><subject>Stress Disorders, Post-Traumatic - psychology</subject><subject>Time Factors</subject><subject>Trauma Severity Indices</subject><subject>Wounds and Injuries - psychology</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kk1v1DAQhiMEokvhD3BAPnJJ8OTbEkKqWmArLeKjRcDJmrUnXS9JvNhOpfwe_igOWzhw4GSN5n1fa-aZJHkKPAMO9Yt9hofBZTmHMuNtxnl1L1lBVeRpm8PX-8mKc16kQojiJHnk_T6WdVXAw-Qkr6CpoIZV8nNt_cEE7NkF9caZaWA4avbBz2pne3tj1NIyPjjynmFgwL4Rut-iNWEfdukn6jGQZh8n7E2Yme3YxnTEzrpAjr2zmlzsp8GmV3RLjti1w2nAYBS7HPeTm9kXE3Z2CrEMDpXD0cRP1zRY53Z4Q4-TBx32np7cvafJ5zevr8_X6eb928vzs02qSoCQgkaqtYKuxLIWGiFXdYuqRl1Csy2Q2rooyg63um3KuIpOgwACUZdlTkLnxWny_Jh7cPbHRD7IwXhFfY8j2clLqHMhmqZoRJTmR6ly1ntHnTw4M6CbJXC5wJF7ucCRCxzJWxnhRNOzu_xpO5D-a_lDIwpeHgUUp7w15KRXhkZF2jhSQWpr_p__6h-76s24EPxOM_m9ndwY9ydB-lxyebWcx3IdUHLgvBXFL4Aot_w</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Abraham, Christine M., MA</creator><creator>Obremskey, William T., MD, MPH</creator><creator>Song, Yanna, MS</creator><creator>Jackson, James C., PsyD</creator><creator>Ely, E. Wesley, MD, MPH</creator><creator>Archer, Kristin R., PhD, DPT</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20141201</creationdate><title>Hospital Delirium and Psychological Distress at 1 Year and Health-Related Quality of Life After Moderate-to-Severe Traumatic Injury Without Intracranial Hemorrhage</title><author>Abraham, Christine M., MA ; Obremskey, William T., MD, MPH ; Song, Yanna, MS ; Jackson, James C., PsyD ; Ely, E. Wesley, MD, MPH ; Archer, Kristin R., PhD, DPT</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-1dae6dc1f4a469da12c68ac6ad417b3ae86334fabd874006fd191e196442e9d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Delirium</topic><topic>Delirium - psychology</topic><topic>Depression</topic><topic>Depression - epidemiology</topic><topic>Depression - psychology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multiple trauma</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Psychiatric Status Rating Scales</topic><topic>Quality of life</topic><topic>Quality of Life - psychology</topic><topic>Rehabilitation</topic><topic>Stress disorders, post-traumatic</topic><topic>Stress Disorders, Post-Traumatic - epidemiology</topic><topic>Stress Disorders, Post-Traumatic - psychology</topic><topic>Time Factors</topic><topic>Trauma Severity Indices</topic><topic>Wounds and Injuries - psychology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abraham, Christine M., MA</creatorcontrib><creatorcontrib>Obremskey, William T., MD, MPH</creatorcontrib><creatorcontrib>Song, Yanna, MS</creatorcontrib><creatorcontrib>Jackson, James C., PsyD</creatorcontrib><creatorcontrib>Ely, E. Wesley, MD, MPH</creatorcontrib><creatorcontrib>Archer, Kristin R., PhD, DPT</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abraham, Christine M., MA</au><au>Obremskey, William T., MD, MPH</au><au>Song, Yanna, MS</au><au>Jackson, James C., PsyD</au><au>Ely, E. Wesley, MD, MPH</au><au>Archer, Kristin R., PhD, DPT</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hospital Delirium and Psychological Distress at 1 Year and Health-Related Quality of Life After Moderate-to-Severe Traumatic Injury Without Intracranial Hemorrhage</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>95</volume><issue>12</issue><spage>2382</spage><epage>2389</epage><pages>2382-2389</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><abstract>Abstract Objectives To determine whether delirium during the hospital stay predicted health-related quality of life (HRQOL) at 1 year after injury in trauma intensive care unit (ICU) survivors without intracranial hemorrhage, and to examine the association between depressive and posttraumatic stress disorder (PTSD) symptoms and each of the HRQOL domains at 1-year follow-up. Design Prognostic cohort with a 1-year follow-up. Setting Level 1 trauma ICU. Participants Adult patients without intracranial hemorrhage (N=173) admitted to a level 1 trauma ICU. Interventions Not applicable. Main Outcome Measures HRQOL was measured with the Medical Outcomes Study 36-Item Short-Form Health Survey at 1 year after traumatic injury. Results Average delirium duration ± SD was .51±1.1 days. Hierarchical multivariable linear regression analyses did not find a statistical relationship between delirium and HRQOL at 1-year follow-up. However, increased levels of depressive symptoms at 1 year were statistically associated with poorer functioning in all physical and mental health HRQOL domains, whereas PTSD at 1 year was statistically associated with all HRQOL domains except role-physical ( P <.05). Conclusions There was no statistical association between delirium during the hospital stay and HRQOL at 1 year, which may be due to the short time spent in delirium by our study population. Depressive symptoms demonstrated a stronger relationship with mental and physical HRQOL domains at 1 year than PTSD, indicating their own unique pathway after trauma. Findings lend support for the separate assessment and management of depression and PTSD. Additional research on the duration and subtypes of delirium is needed within the trauma ICU population, as the effects are not widely known.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25175161</pmid><doi>10.1016/j.apmr.2014.08.005</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Delirium Delirium - psychology Depression Depression - epidemiology Depression - psychology Female Follow-Up Studies Hospitalization Humans Intensive Care Units Male Middle Aged Multiple trauma Physical Medicine and Rehabilitation Psychiatric Status Rating Scales Quality of life Quality of Life - psychology Rehabilitation Stress disorders, post-traumatic Stress Disorders, Post-Traumatic - epidemiology Stress Disorders, Post-Traumatic - psychology Time Factors Trauma Severity Indices Wounds and Injuries - psychology |
| title | Hospital Delirium and Psychological Distress at 1 Year and Health-Related Quality of Life After Moderate-to-Severe Traumatic Injury Without Intracranial Hemorrhage |
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