Post Intensive Care Syndrome (PICS) physical, cognitive, and mental health outcomes 6-months to 7 years after a major burn injury: A cross-sectional study

• Published in: Burns 2023-02, Vol.49 (1), p.26-33
• Main Authors: Carel, Dan, Pantet, Olivier, Ramelet, Anne-Sylvie, Berger, Mette M.
• Format: Article
• Language: English
• Subjects: Burns - complications; Burns - epidemiology; Cognition; Critical Care; Critically ill; Cross-Sectional Studies; Humans; Intensive Care Units; Major burns; Outcome Assessment, Health Care; Risk factors; Survivor
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2022.10.004

The Post Intensive Care Syndrome (PICS) has been described in intensive care (ICU) survivors, being present in 50% of patients surviving 12 months, with well-defined risk factors. Severely burned patients combine many of these risk factors, but the prevalence of PICS has not yet been documented in burns. The study aimed to answer this question and identify associations of PICS with clinical characteristics. Cross-sectional descriptive study of major burn survivors admitted to the burn ICU between 2013 and 2019. Main inclusion criteria: major burns>20 %BSA and ICU admission. The PICS components were assessed using three questionnaires: 1) Physical with Burn Specific Health Scale-Brief (BSHS-B); 2) Cognitive health with MacNair Cognitive Difficulties Self-Rating Scale (CDS); 3) Mental health with the Hospital Anxiety and Depression Scale (HADS) questionnaire. PICS was considered present if at least one component out of three was abnormal. Data as mean±SD. Among the 288 patients admitted during the period, 132 met the inclusion criteria: 53 patients were finally enrolled. They were aged 44 ± 18 years at the time of injury and burned 24 ± 20 BSA % and stayed 25 ± 44 days in the ICU. PICS was identified in 35 patients (66 %): more than one component was altered in 21 patients (60 %). Principal risk factors were more than 3 general anesthetics, prolonged mechanical ventilation (>4 days), ICU stay (>8 days), and hospital stay (>25 days) PICS occurred in 66 % of major burns with two or three components affected simultaneously in 60 %, i.e. more frequently than in general ICU patients. •Burn patients requiring intensive care present several risk factors favoring the development of PICS.•Five major risk factors were identified:> 3 general anesthetics, severe sepsis, mechanical ventilation> 4 days, ICU stay> 8 days and hospital stay> 25 days.•The 66 % prevalence of PICS is higher than the 50 % value observed in general critical care patients.•Considering the potentially invalidating impact of PICS on quality of life, the preventive measures should be applied in the ICU