Patient-Reported Outcomes Associated With Sedation and Agitation Intensity in the Critically Ill

Am J Crit Care. 2020 Mar 1;29(2):140-144. doi: 10.4037/ajcc2020592.

Abstract

Background: Patient-reported outcomes are essential to understand the relationship between patients' perception of sedation and clinicians' assessments of sedation.

Objectives: To evaluate the association between sedation and agitation indexes and patient-reported outcomes of sedation and analgesia.

Methods: This prospective, single-center, observational study included adult patients who were continuously sedated for at least 24 hours in a medical or surgical/ trauma intensive care unit. Patients were interviewed after sedation was discontinued regarding their satisfaction with the quality of sedation and potentially related factors. The primary outcome was the correlation between sedation and agitation indexes and patient-reported outcomes.

Results: A total of 68 patients were interviewed after sedation. Of these, 29 (42.6%) described their overall feelings about their experience while receiving mechanical ventilation in the intensive care unit as "pleasant". When asked about their desires if they were to experience the situation again, 29 patients (42.6%) reported that they would want more sedation. Agitation index was statistically significantly correlated with several patient-reported outcomes. Receiving mechanical ventilation (r = 0.41, P = .002), the amount of noise (r = 0.34, P = .01), suctioning (r = 0.32, P = .02), difficulty resting or sleeping (r = 0.39, P = .003), inability to communicate by talking (r = 0.36, P = .008), anxiety (r = 0.29, P = .03), panic (r = 0.3, P = .02), and frustration (r = 0.47, P < .001) were associated with a higher agitation index.

Conclusion: Agitation index was significantly associated with several patient-reported outcomes and thus seems to be a promising descriptor of patients' experience.

Publication types

  • Observational Study

MeSH terms

  • Anxiety / complications
  • Communication
  • Conscious Sedation*
  • Critical Illness*
  • Female
  • Frustration
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Noise / adverse effects
  • Panic
  • Patient Reported Outcome Measures*
  • Prospective Studies
  • Psychomotor Agitation*
  • Respiration, Artificial
  • Suction

Substances

  • Hypnotics and Sedatives