Hernández HPA, Pérez MP, Cerón DUW

Language: Spanish
References: 14
Page: 233-237
PDF size: 297.95 Kb.

ABSTRACT

Introduction: Post-Intensive Care Syndrome (PICS) encompasses a set of physical, cognitive, and psychological sequelae that affect survivors of critical illness, compromising functionality and quality of life. Its magnitude in Mexico remains largely unknown. Objective: to determine the incidence of PICS in adult patients discharged from the Intensive Care Unit (ICU) of Hospital Español de México, and to characterize its clinical manifestations and associated factors. Material and methods: a prospective, observational, and descriptive study with an analytical component was conducted. Patients ≥ 18 years old with a minimum ICU stay of 48 hours and discharged alive between April and August 2025 were included. Validated instruments were applied: the Medical Research Council (MRC) scale for muscle strength, the Montreal Cognitive Assessment (MoCA) for cognitive function, and the Depression, Anxiety and Stress Scale (DASS-21) for the psychological domain. Multivariate analysis was performed using binary logistic regression, considering demographic variables and exposure to critical care. Results: a total of 53 patients were included, with an incidence of PICS of 50.9%. Patients with PICS had longer ICU stays (137.2 ± 62.9 versus 68.3 ± 22.6 hours, p < 0.001) and longer duration of mechanical ventilation (39.9 ± 56.1 versus 1.6 ± 5.5 hours, p < 0.001). In the multidimensional assessment, stress was the most frequent psychological alteration, while ICU-acquired muscle weakness emerged as the most relevant physical finding. In the adjusted model, ICU length of stay (OR 4.7, 95%CI 2.8-8.0), duration of mechanical ventilation (OR 2.3, 95%CI 1.28-4.11), and male sex (OR 2.18, 95%CI 1.34-4.10) emerged as independent predictors of the syndrome. The binary logistic regression model included age, sex, ICU length of stay, duration of mechanical ventilation, use of vasopressors, and exposure to mechanical ventilation as a dichotomous variable as predictors. This model showed excellent discriminative ability to identify patients at risk of post-ICU syndrome, with an area under the ROC curve of 0.89 (95%CI 0.79-0.97). This performance indicates that, when comparing a patient with and without the syndrome, the model correctly classifies 89% of cases, supporting its clinical utility as a screening and risk stratification tool. Conclusions: PICS showed a high incidence in this cohort. Psychological stress and ICU-acquired weakness were the most consistent findings, while prolonged exposure to critical care confirmed its role as the main determinant of the syndrome. These results highlight the urgent need to implement structured post-ICU detection and rehabilitation programs in Mexico, with emphasis on systematic assessment of muscle strength and psychological symptoms.

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