%0 Journal Article
%T Long term cognitive dysfunction among critical care survivors: associated factors and quality of life-a multicenter cohort study.
%A Jesus Pereira I
%A Santos M
%A Sganzerla D
%A Robinson CC
%A de Souza D
%A Kochhann R
%A Falavigna M
%A Azevedo L
%A Bozza F
%A Sharshar T
%A Goulart Rosa R
%A Granja C
%A Teixeira C
%J Ann Intensive Care
%V 14
%N 1
%D 2024 Jul 29
%M 39073625
%F 10.318
%R 10.1186/s13613-024-01335-w
%X <B>OBJECTIVE: </B>To identify the prevalence and associated factors of cognitive dysfunction, 1 year after ICU discharge, among adult patients, and it´s relation with quality of life.<BR><B>METHODS: </B>Multicenter, prospective cohort study including ICUs of 10 tertiary hospitals in Brazil, between May 2014 and December 2018. The patients included were 452 adult ICU survivors (median age 60; 47.6% women) with an ICU stay greater than 72 h.<BR><B>RESULTS: </B>At 12 months after ICU discharge, a Montreal Cognitive Assessment (tMOCA) telephone score of less than 12 was defined as cognitive dysfunction. At 12 months, of the 452 ICU survivors who completed the cognitive evaluation 216 (47.8%) had cognitive dysfunction. In multivariable analyses, the factors associated with long-term (1-year) cognitive dysfunction were older age (Prevalence Ratio-PR = 1.44, P < 0.001), absence of higher education (PR = 2.81, P = 0.005), higher comorbidities on admission (PR = 1.089; P = 0.004) and delirium (PR = 1.13, P < 0.001). Health-related Quality of life (HRQoL), assessed by the mental and physical dimensions of the SF-12v2, was significantly better in patients without cognitive dysfunction (Mental SF-12v2 Mean difference = 2.54; CI 95%, - 4.80/- 0.28; p = 0.028 and Physical SF-12v2 Mean difference = - 2.85; CI 95%, - 5.20/- 0.50; P = 0.018).<BR><B>CONCLUSIONS: </B>Delirium was found to be the main modifiable predictor of long-term cognitive dysfunction in ICU survivors. Higher education consistently reduced the probability of having long-term cognitive dysfunction. Cognitive dysfunction significantly influenced patients' quality of life, leading us to emphasize the importance of cognitive reserve for long-term prognosis after ICU discharge.