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A2722 - Validation of a New Diagnostic Tool for Post-Intensive Care Syndrome
Author Block: S. Wang1, D. Allen2, A. Perkins3, P. Monahan4, S. H. Khan5, S. Lasiter6, M. Boustani7, B. A. Khan8; 1Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States, 2Indiana University School of Medicine, Indianapolis, IN, United States, 33Center of Health Innovation and Implementation Science, Center for Translational Science and Innovation, Indiana University School of Medicine, Indianapolis, IN, United States, 4Biostatistics, Indiana University School of Medicine, Indianapolis, IN, United States, 5Pulmonary, Indiana Univ School of Medicine, Indianapolis, IN, United States, 65403 HSB, UMKC School of Nursing and Health Studies, Kansas City, MO, United States, 7Geriatric Medicine, Indiana University School of Medicine, Indianapolis, IN, United States, 8Indiana Univ School of Medicine, Indianapolis, IN, United States.
Rationale: Post-intensive care syndrome (PICS) describes the long-term cognitive, physical, and psychological impairments from critical illness. There is no single, validated instrument to assess impairments in all three domains of PICS. The Healthy Aging Brain Care Monitor Self Report (HABC-M SR) is a 27-item questionnaire, which asks patients to demarcate the frequency of target symptoms (cognitive, physical or psychological) in the past 2 weeks.
Objective: To validate the HABC-M SR as an assessment tool for PICS.
Methods: Intensive care unit (ICU) survivors seen in the Critical Care Recovery Center, an outpatient clinical center for ICU survivors, at Eskenazi Hospital in Indianapolis, IN, completed both the HABC-M SR and standardized measures of cognitive, psychological, and physical functioning. Patients also completed standardized measures for cognition (The Repeatable Battery for the Assessment of Neuropsychological Status or the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Battery (CERAD-NB)); psychological symptoms (Geriatric Depression Scale (GDS-30), Patient Health Questionanaire-9 (PHQ-9), and/or the Post-Traumatic Symptom Scale (PTSS-10)); and physical functioning (Physical Self Maintenance scale (PSMS)). Cronbach’s alpha was used to measure the internal consistency of the scale items. Validity between the HABC-M and the comparison tests was measured using Spearman correlation coefficients. PICS patients were compared to a sample of primary care patients (known as groups validity) using the Mann-Whitney U-test.
Results: 142 participants completed the HABC-M SR and standardized measures. The total scale and all three subscales showed good to excellent internal consistency (Cronbach’s alpha 0.92 for total scale, 0.83-0.84 for subscales). The psychological subscale had the strongest correlations with the standardized measures of psychological symptoms, PHQ-9 (Spearman correlation coefficient 0.73), GDS-30 (0.74), and PTSS-10 (0.68). The cognitive subscale strongly correlated with the delayed memory measure of the CERAD-NB (-0.51). The physical subscale correlated with the PSMS (-0.26). All relationships remained significant after adjusting for age, gender, and education. PICS patients had significantly worse subscales and total HABC-M scores compared to primary care patients.
Conclusion: HABC-M SR functional and psychological subscales are valid tools to rapidly assess PICS symptoms. The cognitive subscale only strongly correlated with one measure of the CERAD. This suggests that patients’ self-reporting of cognitive symptoms from PICS may be of limited utility, and is consistent with patients’ lack of awareness of their symptoms. Future studies will need to examine whether the cognitive subscale for the caregiver version of the HABC-M more strongly correlates with patients’ performance on standardized cognitive measures.