Abstract:

Objective To explore the current situation and influencing factors of post-intensive care syndrome （PICS） in critically ill patients a month after their transfer out，and to provide a basis for formulating individualized intervention measures. Methods By the convenience sampling method，550 patients who were transferred out of the ICU of a tertiary A hospital in Guizhou Province for a month from April to November 2024 were selected as the survey subjects. The general information of the patients was collected and sorted out. During their stay in the ICU，the Barthel Index，the Richards Campbell Sleep Scale，and the Perceived Social Support Scale were employed for evaluation. A month after the patients were transferred out of the ICU，the assessment was completed through telephone follow-up using the Chinese version of the Brain Care Monitoring Questionnaire for Healthy Aging. According to the assessment a month after the patients were transferred out，they were divided into a PICS group and a non-PICS group. Univariate analysis and binary Logistic regression analysis were completed based on the data of the 2 groups. Results A total of 550 questionnaires were distributed，and 442 valid questionnaires were ultimately collected，with a valid questionnaire collection rate of 80.3%. Among them，194 cases（43.9%） were high-risk patients with PICS. Binary logistic regression analysis showed that advanced age，pulmonary infection，total hospitalization time>15 days，and internal environment disorder were the risk factors for PICS in ICU patients（P<0.05）. Conclusion The risk of PICS is relatively high in critically ill patients a month after the transfer. Medical staff need to pay attention to patients who are older，have pulmonary infections and internal environment disorders，and formulate personalized intervention measures for different disease types to improve the long-term health prognosis of patients.

Key words: Critical Patients, Post-Intensive Care Syndrome, Assessment, Root Cause Analysis, Critical Care

摘要：

目的 探讨重症患者转出1个月后ICU后综合征（post-intensive care syndrome，PICS）的发生现状及影响因素，为制订个性化干预措施提供依据。 方法 采用便利抽样法，选取2024年4—11月贵州省某三级甲等医院ICU转出1个月的550例患者作为调查对象，收集其一般资料，并在ICU入住期间完成巴氏量表、理查兹—坎贝尔睡眠量表、领悟社会支持量表的测评，在患者转出ICU的1个月后，采用中文版健康老化大脑护理监测问卷通过电话随访的形式完成测评，根据评估结果，将患者分为PICS高危组与无PICS组，采用单因素分析及二元Logistic回归分析其影响因素。 结果 共发放问卷550份，最终回收有效问卷442份，有效问卷回收率为80.3%。其中，194例（43.9%）为PICS高危患者。二元Logistic回归分析显示，年龄大、肺部感染、总住院时间>15 d、内环境紊乱是ICU转出患者发生PICS的高危因素（P<0.05）。 结论 重症患者转出1个月后PICS发生风险较高，医护人员需关注年龄较大、肺部感染及内环境紊乱的患者，并针对不同病情类型制订个性化干预措施，以改善患者的预后。

关键词: 重症患者, ICU后综合征, 评估, 影响因素分析, 危重症护理