Long-term consequences in survivors of critical illness. Analysis of incidence and risk factors.

This study investigates the incidence of long-term consequences in survivors of critical illness 6 months after ICU care. A retrospective analysis of the risk factors was also completed. METHODS: A mixed-method design was used. A qualitative design was used in the questionnaire study (phase 1), and a quantitative design was used for the retrospective study (phase 2). RESULTS: 116 patients were interviewed. Forty-eight patients (41.4%) reported at least one long-term consequence 6 months after ICU discharge. The most frequent consequences were anxiety (n = 33, 28.4%), depression (n = 32, 27.6%) and chronic pain (n = 24, 20.7%). The interview showed the concurrent caseness of PTSD, anxiety and depression in 14 (12.1%) patients. Observed risk factors were age> 60 years (OR = 2.65, IC = 1.23-5.69; p = 0.0119), trauma diagnosis (OR = 5.3, IC = 1.60-17.76; p = 0.0033), length of mechanical ventilation> 7 days (OR = 2.18, IC = 1-4.74; p = 0.0471) length of ICU stay> 10 days (OR = 2.47, IC = 1.16-5.26; p = 0.0185) and clinical conditions at the ICU admission. The quality of life score was lower if the respondent had long-term consequences. DISCUSSION: A high incidence of long-term consequences is found in survivors of critical illness. In future, studies that investigate interventions to prevent these issues after ICU care are need. PMID: 32242536 [PubMed - in process]
Source: Annali dell Istituto Superiore di Sanita - Category: General Medicine Tags: Ann Ist Super Sanita Source Type: research

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Moderate to severe acute pain occurs in 91% of traumatic injury patients presenting to the emergency department (ED) and suboptimal analgesia is common [1-3]. Timely and adequate pain control is crucial, as inadequate management has been associated with increased morbidity and development of chronic pain, post-traumatic stress disorder, anxiety, and depression [4]. Intravenous (IV) opioids are routinely used for treatment of acute pain in trauma patients, but increasing outpatient use of buprenorphine for opioid use disorder (OUD) and chronic pain poses a new challenge to traditional pain management strategies [5].
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
CONCLUSIONS: We found that there is little evidence for any risk factors involved in the development of acute PTH, whereas no study had assessed risk factors for the development of persistent PTH. Further studies are warranted and should be powered to examine possible risk factors for the development of PTH. Rigorous methodology and standardized monitoring should be prioritized to support high-quality research and validate potential findings. PMID: 32320055 [PubMed - as supplied by publisher]
Source: Headache - Category: Neurology Authors: Tags: Headache Source Type: research
CONCLUSIONS: Evaluative studies on organizations that support Veterans are useful to gauge the effectiveness and impact. Through this study, Veterans expressed perceived strengths and weaknesses of the program so further development and appropriate services will be provided. Similar studies on the impact of non-profit organizations are encouraged. Vet TRIIP significantly impacts the lives of many through stress and pain reduction, potentially preventing suicide. PMID: 32236440 [PubMed - as supplied by publisher]
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
As the physical coronavirus pandemic continues to spread, an emotional pandemic is following fast in its wake. When the whole world is going to pieces, it’s awfully hard for the human mind—a fragile thing in the best of times—to cope, and more and more, doctors are reporting the spread of despair, worry and depression among their patients, especially those already suffering from some form of anxiety disorder. Even before COVID-19 hit its shores, the U.S. was a clinically anxious place. According to the National Institute of Mental Health, just over 19% of all American adults will experience at least one a...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized COVID-19 Source Type: news
 Did you know one in six males are sexually assaulted before their 18th birthday? Unfortunately, many victims are reluctant to come forward due to cultural conditioning. In today’s podcast, Gabe speaks with two psychologists about this very common but somewhat taboo issue. They tackle the prevalent myths surrounding male sexual assault and discuss why so many victims suffer in secrecy. What can be done? Where can survivors reach out for help? Join us for an in-depth talk on this very important and under-discussed topic. SUBSCRIBE &REVIEW Guest information for ‘Male Sexual Assault’ Podcast Episod...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Abuse Children and Teens General Interview Men's Issues Podcast The Psych Central Show Trauma Source Type: blogs
Unstable pelvic ring injuries result from high energy trauma and lead to significant morbidity and mortality [1-3]. Patients who survive have an intense recovery and rehabilitation process that is rarely straightforward. A holistic and collaborative team approach to optimize care for these patients is mandatory. Few studies have addressed long term functional outcomes, including posterior pelvic pain, sexual and/or urinary dysfunction, and neurological deficits [4,5]. Concurrent with these physiologic studies, there appears to be post-traumatic psychological factors such as post-traumatic stress disorder, chronic pain, dep...
Source: Injury - Category: Orthopaedics Authors: Source Type: research
ConclusionsHistory of mental health conditions and duration of the initial opioid prescription were associated with an increased risk of chronic opioid therapy among patients with RA.Key Points•Approximately a third of patients with RA are exposed to opioid analgesics.•Patients with RA and history of mental health disease, especially substance use disorders, who initiate opioid use have an increased risk of chronic opioid therapy.•This study provides insight in an underrepresented population of mainly male patients with RA.
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Comorbidity is the presence of one or more additional conditions co-occurring with a primary condition. In this episode, host schizophrenic Rachel Star Withers with her cohost Gabe Howard will be discussing comorbidity with schizophrenia. Comorbidity is associated with worse health outcomes, more complex clinical management and increased health care costs. Occupational therapist and host of the podcast Occupied, Brock Cook, will be joining us to discuss ways that he works with people with schizophrenia to manage multiple health issues.  Highlights from “Comorbidity with Schizophrenia” Episode [01:28] What ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Antipsychotic Inside Schizophrenia Mental Health and Wellness Psychiatry Psychology Psychotherapy Bipolar disorder and schizophrenia comorbid comorbid psychiatric conditions Comorbidities Comorbidity Diagnosis Of Schizophrenia Livi Source Type: blogs
ConclusionsNeither traumatic exposure nor baseline symptoms of PTSD predicted the treatment outcomes examined here. Despite improvements in both comorbid depression and anxiety, participation in this pain ‐focused CBT program was not associated with improvements in comorbid PTSD. To the extent that changes in PTSD symptoms did occur, these were mediated by changes in psychological inflexibility during treatment.SignificancePain ‐focused CBT programs yield clinically meaningful improvements in pain and comorbid symptoms of depression and anxiety, but may have little effect on comorbid PTSD. This raises the issue of whet...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionsNeither traumatic exposure nor baseline symptoms of PTSD predicted the treatment outcomes examined here. Despite improvements in both comorbid depression and anxiety, participation in this pain ‐focused CBT program was not associated with improvements in comorbid PTSD. To the extent that changes in PTSD symptoms did occur, these were mediated by changes in psychological inflexibility during treatment.SignificancePain ‐focused CBT programs yield clinically meaningful improvements in pain and comorbid symptoms of depression and anxiety, but may have little effect on comorbid PTSD. This raises the issue of whet...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
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