Neurocognitive and Psychological Outcomes and Their Correlates in Critically Ill Patients of A Tertiary Care Hospital in Kolkata

SummaryThe proposed study titled “Neurocognitive and Psychological Outcomes and Their Correlates in Critically Ill Patients of a Tertiary Care Hospital in Kolkata” will be a descriptive correlational study. The main aim of the study will be to assess the Neurocognitive and Psychological outcomes in critically ill adult patients admitted in Critical Care Unit. The primary objectives of the study will be to identify the neurocognitive outcome and psychological outcome among the critically ill patients & to find out the correlates of neurocognitive outcome and psychological outcome among the critically ill patients. Sampling will be done by consecutive sampling technique with sample size being two hundred and forty-five. The critically ill adult patients aged between eighteen to sixty years admitted in ICU during the period of data collection with willingness to participate in the study will be the inclusion criteria. Any patients with history of previous psychological disorders, impaired conscious level, mental retardation, and/or with difficulty in speaking or communication will be excluded from the study. The withdrawal criteria will be the patients with unfortunate demise during the period of data collection or any patients taking DORB/DAMA/LAMA. After obtaining formal administrative permission from facility director of NH Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata and ethical clearance from the ethics committee of the same institute, a written informed consent ensuring the willingness for participation in the study will be obtained from the patients/relatives. Initially, a pilot study comprising of ten percent of the sample size will be conducted, after completion of which, the data collection for the proposed study will be commenced. Data from the selected patients will be collected, after establishing rapport and proper self introduction. Patients’ memory regarding stressful events will be assessed by using The Stressful Memory Assessment Checklist for the ICU “SMAC-ICU”. Neurocognitive data will be collected by using Confusion Assessment Method for the Intensive Care Unit “CAM-ICU” (delirium) and Addenbrooke’s Cognitive Examination - ACE-III (cognitive status) while psychological data will be collected by using Hospital anxiety and Depression Scale “HADS” (anxiety & depression). Clinical profile will be assessed by using record analysis proforma which will include working diagnosis, cause of Critical Care Unit stays, type of ventilatory support, duration of mechanical ventilation, weaning failure, events of re-intubation, the reason for the need of mechanical ventilation and APACHE III score. Data regarding the correlates will consist of age, gender, co-morbidities, memory of stressful events, total length of ICU stay, total length of hospital stay, duration of sedation used, oxygen administration status, arterial blood gas values, vital parameters, blood parameters, medication history, presence and nature of indwelling catheters and its duration. Data analysis will be done by appropriate statistical tests.