Long-term cognitive impairment is a significant public health problem. In the October 3 issue of the New England Journal of Medicine, the BRAIN-ICU Investigators, led by Pratik Pandharipande, MD, conducted a multicenter, prospective cohort study to estimate the prevalence of long-term cognitive impairment after critical illness and to test the hypothesis that patients with a longer duration of delirium and a higher sedative and analgesic requirement have more severe cognitive impairment up to 1 year after hospital discharge.
Adults admitted to a medical or surgical ICU with respiratory failure, cardiogenic shock, or septic shock were included. While hospitalized, they were evaluated for delirium and level of consciousness daily with the use of the Confusion Assessment Method for the ICU (CAM-ICU) and the Richmond Agitation-Sedation Scale (RASS). Global cognition and executive functions were assessed three and 12 months after discharge with the use of the Repeatable Battery for the Assessment of Neuropsychological Status and the Trail Making Test, Part B. Multiple linear regression with adjustment for multiple variables was used to examine independent risk factors for global cognition scores and secondary outcomes.