Chest
Clinical Investigations in Critical CareEpidemiology of Psychiatric Medication Use in Patients Recovering From Critical Illness at a Long-term Acute-Care Facility
Section snippets
Materials and Methods
The design was a retrospective cohort study of randomly selectedpatient admissions to a long-term acute-care hospital (Vencor Hospital, Minneapolis, MN). The facility has a census of approximately 50patients and is staffed predominantly by internal medicine physicianswith subspecialty training in pulmonary or renal disease.
Random sampling of medical records from 1995 through 1998 was performedby matching consecutive three-digit numbers from a random number tableto the last three digits of
Results
Two hundred thirty-five records were randomly selected from 989admissions to the facility from 1995 through 1998. Eighty-nine chartswere eligible for abstraction. Ineligible charts (subjects nottransferred directly from an ICU to the study facility or with an ICUstay of < 1 week) included patients with acute and chronic neurologicdisorders, complicated surgical wounds and decubitus ulcers, orthopedicconditions, and long-term dialysis patients with medical illnesses. Thesample was 57% male, with
Discussion
Patients recovering from critical illness must overcome bothphysical and psychological challenges if they are to return to anacceptable level of functioning. It is possible that major depression, adjustment, and anxiety disorders impede progress toward importantgoals such as weaning from mechanical ventilation; however, supportiveevidence for this hypothesis is anecdotal.17 In thisstudy, 37% of patients not previously receiving an antidepressant werestarted on pharmacotherapy usually within the
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Cited by (24)
Psychotropic medication use in former ICU patients with mental health problems: A prospective observational follow-up study
2020, Journal of Critical CareCitation Excerpt :One other study followed patients leaving the ICU for a long-term, acute-care facility. In this study group, 47% of the patients used an antidepressant (two-thirds initiated their antidepressant after ICU discharge) in the first few weeks after ICU discharge [26]. In our study group, only one in six patients used antidepressants 1 year after discharge, and only 6.5% of the patients with mental health problems initiated an antidepressant.
Risk factors for depression and anxiety in survivors of acute respiratory distress syndrome
2010, General Hospital PsychiatryCitation Excerpt :Over 100,000 ARDS survivors per year [1] are at risk for long-term morbidity [7,8] including decreased physical function [8], decreased quality of life [9,10], development of psychiatric disorders [7,11,12] and neurologic injury (i.e., polyneuropathy, encephalopathy, and cognitive sequelae) [7,8]. Psychiatric morbidity such as depression and anxiety are common morbidities of critical illness [10,12--14]. The combination of medications, traumatic stress, pain, inflammation, hypoxemia and brain injury may contribute to psychiatric disorders following critical illness and ICU treatment [13,15,16].
Quality of Life, Emotional Abnormalities, and Cognitive Dysfunction in Survivors of Acute Lung Injury/Acute Respiratory Distress Syndrome
2006, Clinics in Chest MedicineCitation Excerpt :Little is known regarding the effects of treating depression with antidepressant medications or therapy. A study that assessed antidepressant treatment of depression in patients who had ALI/ARDS 2 months after ICU discharge found 37% of patients were taking antidepressant medications [60]. Although data are accumulating regarding depression after ALI/ARDS, less is known regarding anxiety.
Epidemiology of depression and antidepressant therapy after acute respiratory failure
2006, PsychosomaticsCitation Excerpt :Of all survivors, 49% received antidepressant medications. This is similar to the prevalence (47%) that was previously reported in patients recovering from catastrophic illness at an acute rehabilitation center.31 These data illustrate the widespread use of antidepressants in patients with serious medical illnesses and suggest that additional research on the safety and efficacy of these medications in critically ill patients is needed.
Palliative care of the chronically critically ill patient
2002, Critical Care ClinicsLiberation from prolonged mechanical ventilation
2002, Critical Care Clinics
Supported by National Heart, Lung, and Blood Institute grants, P50HL50152 and K23HO04073.
Presented in abstract form at The American Thoracic Society International Conference, San Diego, CA, April 27, 1999.