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64 S C O P E O F C R I T I C A L C A R E

TABLE 4.5 Summary of studies examining Posttraumatic Stress Symptoms (PTSS) in survivors of a critical care

First author/ Instrument/
a
Country Design n/Male Cohort Acuity /ICU LOS Age cut-off score Main findings
Perrins Prospective 38/– General ICU; 6 weeks, —/6 49 IES/- Avoidance and
101
(1998) /UK 6 & 12 months intrusion scores
post-ICU discharge reduced at 12
months; scores
associated with
patients’ recollection
of ICU – those with
no recall had higher
scores
Schelling Retrospective 80/51% ARDS; patients 22/31 36 PTSS > 35 25% scored above
(1998) / cross- discharged over 10 cut-off score;
73
Germany sectional year period symptoms
associated with the
number of traumatic
memories of ICU
Nelson Cross- 24/58% 19 months (mean) after 58/27 40 7 item Significant correlation
(2000) /UK sectional acute lung injury questionnaire with days of
90
sedation and days of
neuromuscular
blockade and PTSS
scores
Scragg Cross- 80/52% Admitted to ICU over -/- 57 IES ≥ 20 12% high levels of
88
(2001) /UK sectional previous 2 years avoidance, 8% high
levels of intrusive
thoughts. Younger
patients had higher
IES scores
Jones (2001) / Cohort study 30/66% General ICU; 2 & 17/8 57 IES Patients with no factual
57
UK 8 weeks but who reported
delusional memories
had higher IES
scores at 8 weeks
Jones (2003) / RCT 116/61% General ICU patients – 17/14 58 IES >19 Patients who received
91
UK 3 hospitals; 8 weeks 6-week rehabilitation
and 6 months after program had lower
discharge IES scores at 8 weeks
but not 6 months;
51% scored >19 at
6 months
Kress (2003) / RCT 32/58% Medical ICU; 11–14 Control 18.4/12.8; 48 IES; structured Evaluated the effect of
68
USA months after hospital Intervention clinical daily sedation
discharge 16.2/6.9 interview withdrawal; patients
in the intervention
group reported
lower IES scores
(not statistically
significant); 6
patients in the
control group were
diagnosed with
PTSD compared with
no patient in the
intervention group
Cuthbertson Prospective 78/72% General ICU 3 months 18/5.6 58 DTS ≥27 – high 22% demonstrated
(2004) /UK cohort after discharge level high level of PTS
74
≥40 PTSD symptoms and 12%
confirmed PTSD