ICU Patients May Develop PTSD Up to One Year After Discharge

Approximately one in ten patients admitted to the intensive care unit (ICU) is at risk of having a new case of post-traumatic stress disorder (PTSD) related to their ICU experience up to one year after hospital discharge, according to a new study of veterans and civilians.

PTSD is commonly found in patients after experiencing the traumatic events of a critical illness. The study findings provide estimates on new cases of PTSD occurring as a direct result from an  ICU experience. Pre-existing PTSD has rarely been systematically evaluated in previous studies, and this study took extra effort to distinguish pre-existing PTSD from new PTSD cases.

Non-veteran patients have dominated the literature of PTSD after critical illness, and this study is the first to also include the expanding and aging Veteran population.

For the study, researchers evaluated a total of 181 patients using the PTSD Checklist for the DSM-IV. The patients were assessed at three months and 160 were further assessed at 12 months. PTSD occurred in six to 12 percent of patients within one year following hospitalization.

“Although lower than prior research and public perception suggests, the rate of ICU-related PTSD is very comparable to the eight percent PTSD rates seen in current and former service members deployed to the recent Iraq and Afghanistan conflicts,” said study leader Mayur Patel, M.D., MPH, FACS, Assistant Professor of Surgery & Neurosurgery at Vanderbilt University Medical Center.

“It is important to understand more about PTSD following the traumatizing events of a critical illness so we can better support the growing number of ICU survivors.”

While looking for risk factors for ICU-related PTSD, the researchers found that pre-existing PTSD as well as prior depression were strong risk factors associated with ICU-related PTSD at three and 12 months post-discharge.

Being a veteran, however, did not increase the risk of ICU-related PTSD, nor did duration of delirium, amount of pain medication, or amount of sedatives taken.

“Currently, the international psychological aftercare for ICU survivors is not organized proactively; rather, it is largely reactive in response to disabling reports from survivors, caregivers, and primary care providers,” write the authors.

“The Institute of Medicine in the United States has recommended a systematic collection, analysis, and dissemination of data assessing the quality of post-conflict PTSD care in the military and veteran populations. We suggest that the same should apply to the large civilian and veteran populations of critically ill survivors,” the authors advised.

The study titled “Incidence and Risk Factors for ICU-related Posttraumatic Stress Disorder in Veterans and Civilians” is published in the American Journal of Respiratory and Critical Care Medicine.

Source: American Thoracic Society

Nurse checking on patient in ICU photo by shutterstock.