Background. Post intensive care syndrome (PICS) is unfavorable prognostic factor in patients with acute cerebral insufficiency (ACI). Prognostic significance of PICS severity in patients with ACI remains unclear. Objective. To determine prognostic value of PICS severity in patients with ACI. Material and methods. The study included 115 patients with ACI following ischemic or hemorrhagic stroke in acute period of disease. We assessed neurological disorders using the NIHSS scale, ACI severity according to the FOUR scale and the GCS scale. PICS syndrome was diagnosed according to the PICS index in patients with ICU stay≥ 72 hours. Significance of this index for outcomes in patients with ACI was determined. We analyzed dependence of probable mortality on ACI severity as of day 3 for PICS score ≥3 and <3. Results. In comparative analysis of PICS modalities in ACI patients on day 3, decrease in gravitational gradient prevailed in 44.3% of patients and decrease in exercise tolerance in 64.3% of patients. Comparison of PICS modalities according to ACI severity revealed significant differences for complications such as decreased gravity gradient, polymyoneuropathy of critical conditions, respiratory polymyoneuropathy, dysphagia. The share of favorable outcomes (GOS grade 3—5) in patients with PICS index <3 was higher (60.7%) compared to patients with PICS index ≥3 (24.1%). According to regression analysis, PICS affects the risk of death in patients with ACI and FOUR score 4—13. Conclusions. The PICS index has high sensitivity and specificity for predicting death in patients with acute cerebral insufficiency. Regression analysis showed that unfavorable outcome is significantly more common in severe PICS (p<0.005). At the same time, PICS index ≥3 is associated with worse prognosis compared to PICS index <3 in patients with FOUR score 4—13 on day 3.
Ershov et al. (Thu,) studied this question.