Symptom and Quality of Life after Intensive Care in Japan

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K10929
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58060:Clinical nursing-related
• Research Institution: Sapporo City University
• Principal Investigator: Takeshi Unoki 札幌市立大学, 看護学部, 教授 (40465232)
• Co-Investigator(Kenkyū-buntansha): 升田 好樹 札幌医科大学, 医学部, 教授 (10244328) ; 櫻本 秀明 茨城キリスト教大学, 看護学部, 准教授 (20755590) ; 井上 貴昭 筑波大学, 医学医療系, 教授 (60379196) ; 宇都宮 明美 京都大学, 医学研究科, 准教授 (80611251)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 集中治療 / 集中治療室 / 集中治療後症候群 / メンタルヘルス / PICS

Outline of Final Research Achievements

An ambidirectional cohort study was conducted at 12 ICUs in Japan. Patients who stayed in the ICU for > 3 nights and were living at home for 1 year afterward were included. One year after ICU discharge, we retrospectively screened patients and performed a mail survey on a monthly basis, including the Impact of IER-S, HADS, and EQ-5D-L questionnaires. 854 patients were surveyed by mail. Of these, 778 patients responded (response rate = 91.1%). The data from 754 patients were analyzed. The prevalence of suspected PTSD, anxiety, and depression were 6.0%, 16.6%, and 28.1%, respectively. EQ-5D-L scores were lower in our participants than in the sex- and age-matched Japanese population. Unplanned admission was an independent risk factor for more severe PTSD, anxiety, and depressive symptoms. Approximately one-third of patients in the ICU population experienced mental health issues one year after ICU discharge. Unplanned admission was an independent predictor for more severe PTSD symptoms.

Free Research Field

クリティカルケア看護学

Academic Significance and Societal Importance of the Research Achievements

本研究は、未だ国民に広く知られているとは言い難い、集中治療後症候群（Post-Intensive Care Syndrome）の実態を調査した、現在までの日本では最も大規模な研究である。重要な知見としては、身体機能の低下のみならず、1/3の患者様が、退室から1年後もうつや不安といったメンタルヘルスの問題を抱えているということである。実態が明確になりつつあるため、今後は、これらのメカニズムの解明、予測システムの構築、地域におけるケアのあり方等を検討する必要がある。