Effects of person-centred care and intensive care experience on post-intensive care syndrome in critical care survivors: a multi-centre prospective cohort study

Effects of person-centred care and intensive care experience on post-intensive care syndrome in critical care survivors: a multi-centre prospective cohort study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effects of person-centred care and intensive care experience on post-intensive care syndrome in critical care survivors: a multi-centre prospective cohort study Jiyeon Kang, Seonyoung Yun This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4263750/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Several risk factors for post-intensive care syndrome have been recognised, but the majority of them cannot be altered. While there is potential for negative experiences in the intensive care unit and person-centred care to impact post-intensive care syndrome, the evidence linking the three is insufficient. This study aimed to investigate the impact of person-centred care and the patient’s experience in the intensive care unit on post-intensive care syndrome among critical care survivors during the first year following hospital discharge. Methods: The study was a prospective, multi-centre longitudinal cohort study. This study was conducted in 19 intensive care units at four university hospitals located in Busan, South Korea. The participants were 618 adults who had been admitted to the intensive care unit for more than 24 hours between May 2019 and July 2021. At the time of intensive care unit discharge, participants completed a person-centred care and an intensive care experience questionnaire. We evaluated the post-intensive care syndrome of the participants 3, 6 and 12 months after hospital discharge. Results: The frightening experience in the intensive care unit was a factor that significantly increased post-intensive care syndrome at 3 and 6 months. Person-centred care partially mediated the impact of the frightening experience on post-intensive care syndrome, mitigating its effect. Female gender, older age, comorbidities, delirium and discharge to an extended care facility were factors that increased post-intensive care syndrome at 3, 6 and 12 months. Furthermore, comorbidities and discharge place had a statistically significant influence on the participants' post-intensive care syndrome changes over the course of one year. Conclusions: The findings of this study support the development and implementation of person-centred interventions that reduce patients' frightening experiences in the intensive care unit in order to enhance long-term outcomes. Additionally, the post-intensive care syndrome of survivors who are discharged to an extended care facility requires special attention. Registration: This study is registered at the Korean Clinical Research Information Service (#KCT0004045; date of registration: June 11, 2019; date of 1 st participant recruitment: June 7, 2019). Critical Care Outcomes Intensive Care Units Patient Experience Person-Centred Care Post-Intensive Care Syndrome Figures Figure 1 Figure 2 Background For the majority of patients and their families, being admitted to the intensive care unit (ICU) is a significant and unexpected occurrence. Regardless of diagnosis or disease severity, ICU patients suffer from physical and emotional distress including sleep deprivation, pain, annoyance from tubes and lines, thirst, isolation, anxiety and fear, embarrassment and lack of information [ 1 ]. Some patients characterise their experience with intensive care as ‘unrealistic’ or ‘inhumane’ [ 2 , 3 ]. Additionally, more than half of ICU patients may develop delirium, an acute brain dysfunction characterised by altered consciousness and behaviour [ 4 , 5 ]. Due to these negative experiences, the incidence of posttraumatic stress disorder (PTSD) among ICU patients reaches 20%, and their PTSD may persist long after being discharged [ 6 , 7 , 8 ]. ICU survivors experience various aftereffects, and the health challenges they face are called post-intensive care syndrome (PICS) [ 9 ]. Among 2,345 survivors in the Netherlands, 43–58% experienced new-onset PICS after ICU admission [ 10 ]. In a comprehensive meta-analysis, age, female gender, previous mental health problems, disease severity, delirium and negative ICU experience were reported as risk factors that significantly increased the incidence of PICS. The last two of those can be considered modifiable and nursing-sensitive factors [ 11 ]. Delirium and a negative intensive care experience (ICE) are related, and strategies to address them are consistent with recent advances in person-centred care (PCC) [ 9 ]. PCC is professional care that respects patients as unique individuals while providing empathy, communication, advocacy and comfort [ 12 ]. It is also called patient- and family-centred care (PFCC) in the ICU [ 13 ]. Various types of interventions, including early comfort, sleep promotion, appropriate communication, family engagement and palliative care, have been proposed as PCC for critically ill patients [ 14 , 15 ]. According to relevant qualitative studies, PCC has the potential to enhance the ICE of patients [ 2 , 16 ]. PCC interventions are also associated with patient and family satisfaction and may improve their mental health or reduce resource utilisation in the ICU [ 17 ]. PCC provision in the ICU is challenging. One of the most important parts of PCC is patient participation, but it's hard to do in the ICU because of the severity of the patient’s disease. As a result, there are few studies on how shared decision-making or empowerment strategies can improve patient outcomes [ 18 ]. Additionally, empirical studies on PCC are limited due to the broad and comprehensive nature of the concept. To date, the majority of related studies have only reported the effects of individual PCC interventions, and there is a dearth of empirical research and evidence on PCC as a holistic concept and its long-term effects. Consequently, the purpose of this study was to investigate the effect of patients' perceived level of PCC and their ICE on PICS, the long-term outcome of critical care. Methods Design This was a second-year study of a multi-centre cohort project on PICS and associated risk factors in ICU survivors. We adopted a longitudinal study design to determine the impact of PCC and ICE on survivors' PICS after discharge. The study findings on the relationship between PCC and ICE, which was the subject of the first year of this initiative, have been published elsewhere (blinded for review). The study protocol was registered with the Korean Clinical Research Information Service (#KCT0004045; date of registration: June 11, 2019; date of 1st participant recruitment: June 7, 2019). Setting and Sample This study was conducted in 19 adult ICUs at four university hospitals located in Busan, South Korea. The size of the participating hospitals was 812-1,205 beds. We included 618 patients who were admitted to one of the ICU between May 2019 and July 2020 and met the following criteria: (1) age over 18 years, (2) ICU stay longer than 24 hours, and (3) those who responded at least once to the follow-up surveys conducted 3, 6 and 12 months after discharge. The exclusion criteria were patients who (1) had been admitted to the ICU within the past year, (2) had been diagnosed with a physical disability or mental health problem prior to ICU admission, or (3) whose cognitive limitations prevented them from responding to the questionnaire. Measurements Patient-centred care We assessed participants’ perceptions of PCC using the Person-Centered Critical Care Nursing-Patient Version Questionnaire, which was developed and validated by Hong and Kang [ 12 ]. The questionnaire consists of 20 items and five factors: compassion, expertise, communication, comfort and respect. Items are responded to using a 4-point Likert scale. The higher the total score, the more patients perceive that the care they received was person-centred. Hong and Kang [ 12 ] reported a Cronbach’s alpha of .93. Cronbach’s alpha in the present study was .90. Intensive care experience The Korean version of the Intensive Care Experience Questionnaire (K-ICEQ) was used to measure participants’ ICE [ 19 ]. This tool was a cultural adaptation and validation of the original ICEQ [ 20 ] developed in the United Kingdom to suit the Korean context. The questionnaire has 26 items that are responded to using a 5-point Likert scale and comprises four subscales: Awareness of Surroundings (ICE-Awareness), Frightening Experiences (ICE-Frightening), Satisfaction with Care (ICE-Satisfaction) and Recall of Experiences (ICE-Recall). Scores are calculated for each subscale. The ICE-Awareness score ranges from 8 to 40, and a higher score indicates that the patient was well aware of the people, surroundings and circumstances in the ICU. The score for ICE-Frightening ranges from 9 to 45, with higher scores indicating that the ICU experience was shocking and traumatic. The score range for ICE-Satisfaction is 5–25, and a higher score means that the evaluation of the treatment and nursing received during the ICU stay was more favourable. The score range for ICE-Recall is 4–20, and a higher score indicates that the patient recalls the ICU experience without any distortion, reduction or processing. Kang and Cho [ 19 ] reported the following Cronbach's alpha coefficients: ICE-Awareness = .93, ICE-Frightening = .80, ICE-Satisfaction = .74 and ICE-Recall = .76. In our study, Cronbach's alphas were .79, .79, .68 and .48, respectively. Post-intensive care syndrome We measured participants' PICS with the Post-Intensive Care Syndrome Questionnaire developed and validated by Jeong and Kang [ 21 ]. The questionnaire has 18 items that are responded to using a 4-point Likert scale and comprises three factors: physical, mental and cognitive problems. Total scores range from 0–54, and the higher the score, the more severe the PICS. Jeong and Kang [ 21 ] reported a Cronbach’s alpha of .93. In the present study, Cronbach’s alphas at 3, 6 and 12 months after discharge were .90, .89 and .89, respectively. Ethical consideration The Institutional Review Boards of X University and the four participating hospitals approved this study (2-1040709-AB-N-01-201904-HR-021-06, H-1907-015-080, 19–0096, KUGH 2019-05-014-002). We publicly recruited participants by posting notices about the study in the ICUs. We thoroughly explained the purpose and methods of the study, the confidentiality of personal information, and the voluntary nature of participation to ensure participants’ understanding. All participants provided written informed consent for the study. Procedure Data collection was conducted in two phases: pre- and post-hospital discharge. The first phase of the survey was conducted in the patient’s room or lounge within a week after the participants were moved from the ICU to the general ward. Completing the questionnaire took 10 to 15 minutes. The PCC and ICE measures had to be completed by the participants independently. If this proved to be too difficult, a research assistant read the questionnaire to the participant and filled in their responses. Data on disease and treatment-related characteristics were extracted from the electronic medical records. The second phase of data collection was the PICS assessment, which was conducted at 3, 6 and 12 months after hospital discharge. Initially, the survey was administered face-to-face to participants during their follow-up visits to the hospital. However, as of March 2020, all surveys were conducted via telephone due to the coronavirus disease (COVID-19) pandemic. The survey was executed in adherence to a clearly established protocol by a group of five research assistants. To mitigate discrepancies among the research assistants, regular seminars and training sessions were organised. Statistical Analysis We used IBM SPSS Statistics version 26.0 (IBM Corp.; Armonk, NY) to analyse the data. Descriptive statistics were calculated for the demographic characteristics, treatment-related characteristics, PCC, ICE and PICS as frequencies, percentages, means and standard deviations. A standard score was computed to assess the severity of the disease, given that the instrument used by each hospital varied, specifically either acute physiology and chronic health evaluation II (APACHE II) or Simplified acute physiologic score 3 (SAPS 3). We analysed differences in PICS according to participant characteristics using a t-test and a one-way ANOVA. The correlations between PCC, ICE and PICS were analysed using Pearson’s correlation coefficients. Using multiple regression, the effects of PCC and ICE on PICS 3, 6 and 12 months after discharge were analysed. We examined multicollinearity and autocorrelation for the assumptions of regression analysis. The variation inflation factor of the regression models varied between 1.12 and 2.36, with values not surpassing 10, and the tolerance ranged from 0.5 to 0.9, with values exceeding 0.1. Consequently, there was no multicollinearity among the independent variables. Additionally, the Durbin-Watson values for each model were near 2 (1.81, 1.92 and 1.85), indicating that autocorrelation was not a concern. Hierarchical regression and path analyses were employed to examine the mediating effect of PCC in the relationship between ICE and PICS. In order to evaluate the significance of the indirect effect, PROCESS macro model 4 was employed, utilising 5,000 bootstrap samples and a 95% confidence interval (CI). Changes in PICS over time were analysed using repeated-measures ANOVA, and Mauchly's test value was .95, which was greater than .05, satisfying the sphericity assumption. We analysed the factors influencing PICS changes over time using the linear mixed model (LMM). To reduce bias and maximise statistical power, missing data were imputed. The process of imputation was executed by combining predictive mean matching with multivariate imputation. All statistical significance levels were set at p < .05. Results Participants’ characteristics A total of 9,135 patients were admitted to the ICUs during the study period. Of these, 1,652 patients expressed their intention to participate, and among them, 891 who met the inclusion criteria completed the PCC and ICE questionnaires in the first phase of the survey. From the first phase participants, 618 who completed the second phase survey at least once in 3, 6 and 12 months following hospital discharge were included as the final participants for this study (Fig. 1 ). The average age of the participants was 60.15 ± 13.27 years, and 59.7% of them were men. Prior to ICU admission, 57.3% had a functional comorbidity index (FCI) ≥ 1, and 14.2% developed delirium in the ICU. Their average ICU stay was 4.65 ± 7.79 days, and most (83.8%) participants were discharged to their home. The average PICS scores at 3, 6 and 12 months were statistically significantly different depending on the participants' gender, age, employment, FCI, delirium, length of ICU stay and discharge place (Table 1 ). Table 1 Differences in post-intensive care syndrome according to characteristics of the participants (N = 618) Variables Categories Mean ± SD n (%) or PICS 3 months 6 months 12 months Mean ± SD t or F p Mean ± SD t or F p Mean ± SD t or F p 8.81 ± 7.72 7.49 ± 6.63 11.13 ± 7.91 40.91* < .001 Gender Man Woman 369 (59.7) 249 (40.3) 7.82 ± 6.71 10.27 ± 8.83 -3.91 < .001 6.83 ± 6.44 8.46 ± 6.80 -3.026 .003 10.41 ± 7.78 12.20 ± 7.99 -2.763 .006 Age < 60 ≥ 60 60.15 ± 13.27 268 (43.4) 350 (56.6) 7.40 ± 6.67 9.89 ± 8.29 4.01 < .001 6.39 ± 6.89 8.32 ± 6.32 3.622 < .001 9.14 ± 7.70 12.66 ± 7.73 5.612 < .001 Employment Yes No 285 (46.1) 333 (53.9) 7.20 ± 6.35 10.19 ± 8.50 -4.90 < .001 6.59 ± 6.53 8.25 ± 6.64 -3.129 .002 9.41 ± 7.15 12.61 ± 8.23 -5.111 < .001 FCI prior to ICU admission 0 1 ≥ 2 264 (42.7) 205 (33.2) 149 (24.1) 6.78 ± 6.04 8.67 ± 7.50 12.60 ± 9.19 29.54 < .001 6.73 ± 6.20 7.00 ± 6.27 9.49 ± 7.45 9.310 < .001 9.96 ± 7.42 10.66 ± 7.79 13.86 ± 8.29 12.590 < .001 Reason for ICU admission Medical disease Postoperative Neurologic disease Trauma Cardiovascular disease 105 (17.0) 181 (29.3) 166 (26.9) 47 (7.6) 119 (19.3) 9.71 ± 7.89 7.71 ± 6.97 8.72 ± 8.05 9.40 ± 6.51 9.58 ± 8.52 1.66 .158 8.71 ± 7.24 6.43 ± 5.79 7.20 ± 7.37 7.77 ± 5.31 8.29 ± 6.47 2.600 .035 12.03 ± 8.44 9.85 ± 7.51 10.81 ± 7.84 11.94 ± 8.12 12.43 ± 7.80 2.543 .039 Admission route Emergency room Ward 321 (51.9) 297 (48.1) 9.26 ± 8.03 8.33 ± 7.36 1.50 .134 7.88 ± 7.04 7.06 ± 6.15 1.533 .126 11.31 ± 7.84 10.94 ± 7.99 0.595 .552 Disease severity APACHE Ⅱ SAPS 3 Standardized score < 0 ≥ 0 11.50 ± 6.31 34.24 ± 16.13 0.03 ± 0.95 313 (50.6) 305 (49.4) 8.36 ± 7.94 9.27 ± 7.48 -1.46 .145 7.41 ± 6.82 10.80 ± 7.81 -0.303 .762 10.80 ± 7.81 11.48 ± 8.00 -1.074 .283 Mechanical ventilator Yes No 119 (19.3) 499 (80.7) 8.87 ± 7.79 8.80 ± 7.71 0.09 .931 9.10 ± 7.14 7.10 ± 6.45 2.975 .003 11.45 ± 8.14 11.06 ± 7.85 0.480 .631 Surgery Yes No 338 (54.7) 280 (45.3) 8.14 ± 7.35 9.63 ± 8.09 -2.40 .017 7.07 ± 6.26 7.99 ± 7.03 -1.709 .088 10.81 ± 7.87 11.52 ± 7.94 -1.103 .271 Delirium Yes No 88 (14.2) 530 (85.8) 11.81 ± 8.12 8.31 ± 7.55 3.98 < .001 11.25 ± 7.22 6.86 ± 6.32 5.905 < .001 14.81 ± 9.38 10.52 ± 7.47 4.791 < .001 ICU days < 4 ≥ 4 4.65 ± 7.79 397 (64.2) 221 (35.8) 8.28 ± 7.54 9.76 ± 7.96 -2.26 .024 6.91 ± 6.42 8.52 ± 6.90 -2.840 .005 10.35 ± 7.62 12.54 ± 8.23 -3.325 .001 Discharge place Home Extended care facilities 518 (83.8) 100 (16.2) 8.40 ± 7.37 10.93 ± 9.09 -3.02 .003 6.85 ± 6.13 10.76 ± 8.07 -5.519 < .001 10.74 ± 7.75 13.19 ± 8.42 -2.859 .004 *Repeated Measures ANOVA on PICS difference over 3, 6, and 12 months. APACHE Ⅱ = acute physiology and chronic health evaluation Ⅱ; FCI = functional comorbidity index; ICU = intensive care unit; PICS = post-intensive care syndrome; SAPS 3 = simplified acute physiologic score 3; SD = standard deviation. Correlations between PCC, ICE and PICS Table 2 presents the mean scores for PCC and ICE during the patient’s ICU stay and PICS at 3, 6 and 12 months after hospital discharge, and the correlations between them. Positive correlations were observed between PCC and ICE-Awareness (r = .37, p < .001) and ICE-Satisfaction (r = .57, p < .001). Conversely, PCC negatively correlated with ICE-Frightening (r = − .36, p < .001). A positive correlation was observed between PICS at 3 months and ICE-Frightening (r = .14, p = .001). At 6 months, PICS had a positive correlation with ICE-Frightening (r = .15, p < .001), whereas it negatively correlated with PCC (r = − .11, p = .009) and ICE-Awareness (r = − .13, p = .002). At 12 months, a negative correlation was observed between PICS and PCC (r = − .15, p < .001), ICE-Awareness (r = − .14, p < .001) and ICE-Satisfaction (r = − .09, p = .030); however, a positive correlation was found with ICE-Frightening (r = .13, p = .001). Table 2 Means, standard deviations and correlations for the study variables (N = 618) Variables Mean ± SD (Range) PCC r ( P ) ICE-Awareness r ( P ) ICE-Frightening r ( P ) ICE-Satisfaction r ( P ) ICE-Recall r ( P ) PICS-3months r ( P ) PICS-6months r ( P ) PICS-12months r ( P ) PCC 60.98 ± 9.62 (20–80) 1 ICE-Awareness 33.05 ± 5.36 (8–40) .37 (< .001) 1 ICE-Frightening 16.51 ± 5.80 (9–45) − .36 (< .001) − .19 (.001) 1 ICE-Satisfaction 19.52 ± 2.64 (5–25) .57 (< .001) .24 (< .001) − .50 (< .001) 1 ICE-Recall 14.54 ± 2.30 (4–20) .50 (.221) .23 (< .001) − .18 (< .001) .19 (< .001) 1 PICS-3months 8.81 ± 7.72 (0–54) − .06 (.142) − .07 (.070) .14 (.001) − .06 (.124) − .07 (.105) 1 PICS-6months 7.49 ± 6.63 (0–54) − .11 (.009) − .13 (.002) .15 (< .001) − .05 (.196) − .03 (.502) .47 (< .001) 1 PICS-12months 11.13 ± 7.91 (0–54) − .15 (< .001) − .14 (< .001) .13 (.001) − .09 (.030) − .04 (.388) .33 (< .001) .42 (< .001) 1 ICE = intensive care experience; PCC = patient centred care; PICS = post-intensive care syndrome; SD = standard deviation. The effect of PCC and ICE on PICS 3, 6 and 12 months after ICU discharge We conducted multivariate regression analyses at each time point to determine the impact of participants' demographic and clinical characteristics, PCC, and the four ICE dimensions on PICS at 3, 6 and 12 months after hospital discharge. For each regression model, those variables that were statistically significant in the univariate analyses were included as independent variables, and all three regression models were statistically significant. Beyond the participant characteristics of female gender (β = .16, p < .001), older age (β = .08, p = .044), FCI = 1 (β = .13, p = .001), FCI ≥ 2 (β = .29, p < .001), delirium (β = .10, p = .016) and discharge to an extended care facility (β = .12, p = .001), ICE-Frightening (β = .09, p = .021) was identified as a factor that significantly increased PICS at 3 months after hospital discharge. ICE-Frightening (β = .09, p = .032) was also a factor that significantly increased PICS at 6 months, in addition to the participant characteristics of female gender (β = .13, p = .001), older age (β = .10, p = .014), FCI ≥ 2 (β = .15, p = .001), delirium (β = .15, p = .001) and discharge to an extended care facility (β = .20, p < .001). At 12 months after discharge, female gender (β = .10, p = .009), older age (β = .15, p < .001), non-employment (β = .10, p = .018), FCI ≥ 2 (β = .15, p = .001), delirium (β = .10, p = .024) and discharge to an extended care facility (β = .08, p = .044) were factors that increased PICS (Table 3 ). PCC had no statistically significant effect on PICS at any time point. Table 3 Effect of person-centred care and intensive care experience on post-intensive care syndrome (N = 618) Variables PICS at 3 months PICS at 6 months PICS at 12 months B SE β t p B SE β t p B SE β t p (Constant) 1.01 1.24 0.82 .414 4.86 3.51 1.38 .167 9.05 4.56 1.98 .048 Gender (ref: male) 2.52 0.61 .16 4.16 < .001 1.77 0.53 .13 3.34 .001 1.66 0.63 .10 2.62 .009 Age (ref: < 60) 1.25 0.62 .08 2.02 .044 1.35 0.55 .10 2.46 .014 2.44 0.66 .15 3.72 < .001 Employment (ref: yes) 1.17 0.63 .08 1.85 .065 0.38 0.56 .03 0.68 .494 1.57 0.66 .10 2.37 .018 FCI prior to ICU admission(= 1) (ref: 0) 2.20 0.68 .13 3.22 .001 0.66 0.60 .05 1.11 .270 0.79 0.71 .05 1.11 .268 FCI prior to ICU admission(≥ 2) (ref: 0) 5.20 0.76 .29 6.85 < .001 2.25 0.66 .15 3.40 .001 2.76 0.79 .15 3.48 .001 Postoperative -1.31 0.78 − .09 -1.67 .096 -0.86 0.93 − .05 -0.92 .358 Neurologic disease -0.91 0.79 − .06 -1.15 .253 0.07 0.94 .00 0.08 .938 Trauma -1.18 1.12 − .05 -1.05 .293 1.03 1.33 .03 0.77 .440 Cardiovascular disease 0.28 0.84 .02 0.34 .738 1.25 1.01 .06 1.24 .216 Admission route (ref: ER) Disease severity Mechanical ventilator (ref: yes) -0.38 0.73 − .02 -0.52 .602 Surgery (ref: yes) 1.08 0.58 .07 1.86 .064 Delirium (ref: no) 2.19 0.90 .10 2.43 .016 2.83 0.83 .15 3.41 .001 2.18 0.96 .10 2.27 .024 ICU days (ref: < 4) 0.20 0.67 .01 0.29 .771 -0.21 0.61 − .02 -0.34 .733 1.00 0.70 .06 1.42 .155 Discharge place (ref: home) 2.60 0.79 .12 3.29 .001 3.60 0.73 .20 4.96 < .001 1.75 0.87 .08 2.02 .044 Person-centred care 0.01 0.03 .01 0.17 .866 -0.05 0.04 − .06 -1.30 .194 ICE- Awareness -0.04 0.05 − .03 -0.75 .455 -0.08 0.06 − .06 -1.33 .183 ICE- Frightening 0.12 0.05 .09 2.32 .021 0.10 0.05 .09 2.15 .032 0.06 0.06 .05 1.02 .310 ICE- Satisfaction 0.02 0.15 .01 0.15 .879 ICE- Recall R 2 .181 .163 .162 Revised R 2 .168 .141 .139 F 13.42 7.34 7.24 p < .001 < .001 < .001 Durbin-Watson 1.81 1.92 1.85 B = unstandardized estimates; ER = emergency room; FCI = functional comorbidity index; ICE = intensive care experience; ICU = intensive care unit; PICS = post-intensive care syndrome; SE = standard error. Given that PCC did not exhibit a statistically significant association with PICS across all three regression models, we examined the mediating effect of PCC in the association between ICE-Frightening and PICS. The results indicated PCC partially mediated the association between ICE-Frightening and PICS at 12 months (B = .06, 95% CI [.01, .11]). Alternatively stated, PCC mitigated the adverse impact of ICE-Frightening on PICS (Fig. 2 ). The mediating effect of PCC was not statistically significant at 3 months or at 6 months (Supplementary Table 1). Factors influencing changes in PICS over time At 3, 6 and 12 months following hospital discharge, the PICS scores of the participants were 8.81 ± 7.72, 7.49 ± 6.63 and 11.13 ± 7.91, respectively; this change was statistically significant (F = 40.91, p < .001) (Table 1 ). The LMM analysis of the factors influencing PICS changes over time revealed that only the FCI and discharge place were statistically significant in relation to participant characteristics, PCC and ICE (Supplementary Table 2). PICS changes were significantly greater for those discharged to an extended care facility (t = 4.81, p < .001) and those with a FCI ≥ 2 (t = -2.79, p = .005) (Supplementary Fig. 1). Discussion We observed that patients’ ICE-Frightening during their stay in an ICU were a risk factor for developing PICS 3 and 6 months after hospital discharge, based on a prospective cohort study of 618 survivors. Although PCC was not identified as a statistically significant protective factor against PICS, it partially mediated the association between ICE-Frightening and PICS at 12 months. Significant change occurred in the PICS of survivors over a period of one year; comorbidities prior to admission and discharge place were influential factors in this change. Of the four dimensions of the ICE that we investigated, only ICE-Frightening was found to significantly worsen PICS. Frightening experience, which includes pain, embarrassment, bad dreams, helplessness and fear of death in the ICU, has been shown to be associated with anxiety, depression and PTSD in survivors after discharge, but empirical evidence on its long-term effects is limited [ 22 ]. This study is significant in that we observed that adverse ICU experiences, such as frightening experiences, can negatively impact survivors' long-term health outcomes after hospital discharge. One of the risk factors that contributes to a negative experience in the ICU is delirium [ 23 ], and the distinction between the two is often difficult to discern. Indeed, survivors who had delirium during their ICU stay described being ‘overwhelmed by fear’ as their most intense experience [ 24 ]. Delirium was a contributing factor to the exacerbation of PICS after discharge in our study. Survivors who experienced delirium exhibited a significantly higher PICS score at all time points. This result aligns with a previous meta-analysis study [ 11 ], which reported that adverse experiences and delirium in the ICU were contributors to the deterioration of survivors' mental health and cognitive functions. Considering the above, it appears that enhancing the ICE, which includes delirium prevention, may result in the prevention or alleviation of PICS in survivors. At 12 months post-discharge from the ICU, PCC partially mediated the relationship between ICE-Frightening and PICS. This result is intriguing because it demonstrates that interventions targeting PCC can mitigate the adverse effects of ICE-frightening and prevent or reduce PICS even further. Recently, PCC or PFCC as a strategy to improve the ICU experience has received research attention [ 9 , 17 , 25 ], and our findings provide evidence of the importance of PCC for intensive care patients. PCC or PFCC interventions promote patient and family participation in care while recognising the distinctive needs of each individual [ 25 ]. The interventions also include environmental factors in the ICU, such as lighting and noise management [ 26 , 27 ]. Kang et al.’s [ 28 ] meta-analysis identified family participation, information provision, lighting and noise blocking as effective in preventing delirium, which can all be classified as PCC interventions. Recent studies [ 29 , 30 ] have reported that virtual visiting or video calling to replace visiting restrictions during the COVID-19 pandemic was effective in preventing delirium and reducing psychological distress in ICU patients. Despite these encouraging outcomes, a meta-analysis found insufficient evidence of significant effects of PCC interventions on post-discharge mental health and ICU delirium [ 25 ]. This finding might be due to the particular PCC interventions—for example, information sharing and ICU diaries—that were included in the meta-analysis. Despite the emphasis on the importance of PCC interventions in the ICU, the variety and extent of these interventions restricts their availability and assessment. It is necessary to develop PCC interventions as protocols or bundles to facilitate their implementation by clinicians, including ICU nurses. In our study, discharge place was a major influencing factor for PICS. Survivors discharged to an extended care facility had more severe PICS. For ICU survivors, an early post-discharge recovery phase is crucial, and poor rehabilitation during this period is associated with a negative outcome [ 31 ]. Leading Western countries are implementing transition programmes and post-ICU clinics to facilitate the rehabilitation of survivors [ 32 , 33 ]. An increasing number of extended care facilities, including nursing homes and rehabilitation hospitals, are proliferating in Korea due to the country's rapidly ageing population; however, the infrastructure, personnel and insurance payment system required to deliver professional rehabilitation in extended care facilities remain underdeveloped [ 34 ]. Limited infrastructure for post-ICU rehabilitation may not be an issue exclusive to Korea. To enhance long-term outcomes for ICU survivors through rehabilitation continuity, links must be established with acute hospitals and extended care facility that are suitable for each country. Female gender, old age and comorbidity were patient-related risk factors that consistently increased PICS over the 12-month period. This result is consistent with findings reported in prior studies [ 11 , 35 ]. Among these, comorbidities prior to ICU admission are emphasised as strong risk factors for long-term health outcomes in survivors [ 35 ]. Our results of the LMM analysis showed that survivors with a greater number of comorbidities prior to admission had a smaller effect on PICS changes over the 12 months. The findings indicate that participants with comorbidities maintained a consistently high PICS score, whereas those without comorbidities experienced a statistically significant increase in score from low levels at 3 months to 12 months. ICU nurses must be aware of patient-related factors, particularly comorbidities, as critical characteristics that can be used to proactively identify PICS risk. The prevalence and duration of PICS vary among survivors, but the severity generally tends to decrease over time [ 36 , 37 ]. The PICS scores of our participants showed a decline from 3 to 6 months, then an increase from 6 to 12 months. One of the reasons for this V-shaped trajectory could be the COVID-19 pandemic situation during the study period. The pandemic inevitably caused social isolation, and this isolation was closely related to the risk of disability and mortality in ICU survivors [ 38 ]. During the post-discharge recovery period, it is reasonable to presume that the daily activities and social interactions of our participants were also restricted. Furthermore, the reason for the greatest PICS scores in the mental domain among our participants can be understood within the same context. This study is significant for the following reasons. First, we established a multi-centre cohort of the general ICU population and conducted follow-up studies, which increased the generalizability of the results. Second, by examining the long-term effects of PCC and ICE, which are nursing-sensitive factors, we contributed to building evidence for the development of critical care nursing interventions. Lastly, this study used a single instrument that integrated the physical, mental and cognitive domains for assessing PICS, which is in contrast to prior studies that reported only select domains or used separate instruments for each domain. In addition to providing participants with convenience, the use of integrated tools can broaden the scope of the analysis. Limitations This study has several limitations. First, the reliability of the ICE-Recall subscale of the K-ICEQ was low. Unlike previous studies [ 19 , 22 ], we implemented the use of this subscale immediately after ICU discharge, which may not have been an appropriate time to measure recall. Given that the K-ICEQ is a tool that assigns scores to each subscale, we suggest future studies choose and utilise specific subscales based on the measurement concept and timing. The participants in our study were survivors who completed questionnaires within the general population of ICU patients, indicating that their disease severity was rather low. It is important to consider this when expanding our findings to patients with more severe diseases like sepsis or respiratory failure. Lastly, although all participants were non-COVID-19 patients, the COVID-19 pandemic during the study period may have had an impact on the PICS of participants; thus, the pandemic should be taken into consideration when interpreting the findings. Conclusion In this multi-centre cohort study, survivors discharged from 19 ICUs were followed-up for 12 months on their PICS and influencing factors. Survivors' ICE-Frightening in the ICU was a statistically significant risk factor for PICS 3 and 6 months after discharge. Comorbidities, delirium, female gender, advanced age and discharge to an extended care facility were factors that increased PICS consistently over a 12-month period. Furthermore, PCC partially mediated the relationship between ICE-Frightening and PICS. Our findings provide empirical support for the assumption that negative experiences in the ICU should be managed to prevent or alleviate PICS in survivors. Enhancing the long-term prognoses of survivors requires the development and evaluation of PCC interventions that are specifically applicable to the ICU. Abbreviations ICU Intensive care unit PTSD Posttraumatic stress disorder PICS Post-intensive care syndrome ICE Intensive care experience PCC Person-centred care PFCC Patient- and family-centred care K-ICQ Korean version of the Intensive Care Experience Questionnaire ICE-Awareness Awareness of Surroundings ICE-Frightening Frightening Experiences ICE-Satisfaction Satisfaction with Care ICE-Recall Recall of Experiences COVID-19 Coronavirus disease APACHE Ⅱ Acute physiology and chronic health evaluation Ⅱ SAPS 3 Simplified acute physiologic score 3 CI Confidence interval LMM Linear mixed model FCI Functional comorbidity index Declarations A uthor s’ contribution s JK: Conceptualization, Funding acquisition, Methodology, Supervision, Writing – original draft, Writing – review and editing. SY: Formal analysis, Writing – original draft, Writing – review and editing. All authors read and approved the final manuscript. Funding This research was supported by the National Research Foundation of Korea (NRF) grant funded by Korea government (MSIT) (no. NRF-2019R1A2C1011300, NRF-2022R1A2C1011917). The funding source had no role in the study design, analysis, data interpretation, or decision to submit for publication. Data availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Acknowledgements Not applicable. Declarations Ethics approval and consent to participate This study was conducted in accordance with the Declaration of Helsinki and was part of a multi-centre cohort project. The Institutional Review Boards of X University and the four participating hospitals approved this study (2-1040709-AB-N-01-201904-HR-021-06, H-1907-015-080, 19-0096, KUGH 2019-05-014-002). We thoroughly explained the purpose and methods of the study, the confidentiality of personal information, and the voluntary nature of participation to ensure participants’ understanding. All participants provided written informed consent for the study. Consent for publication Not applicable . C ompeting interests The authors declare no competing interests. References Latour JM, Kentish-Barnes N, Jacques T, Wysocki M, Azoulay E, Metaxa V. Improving the intensive care experience from the perspectives of different stakeholders. Crit Care. 2022;26(1):218. https://doi:10.1186/s13054-022-04094-x . Kang J, Jeong YJ. Embracing the new vulnerable self: A grounded theory approach on critical care survivors' post-intensive care syndrome. Intensive Crit Care Nurs. 2018;49:44–50. https://doi.org/10.1016/j.iccn.2018.08.004 . Olsen KD, Nester M, Hansen BS. Evaluating the past to improve the future - A qualitative study of ICU patients' experiences. Intensive Crit Care Nurs. 2017;43:61–7. https://doi.org/10.1016/j.iccn.2017.06.008 . Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJC, Pandharipande P, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46(9):e825–73. https://doi.org/10.1097/CCM.0000000000003299 . Pun BT, Badenes R, Heras La Calle G, Orun OM, Chen W, Raman R, et al. Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort study. Lancet Respir Med. 2021;9(3):239–50. https://doi.org/10.1016/S2213-2600(20)30552-X . Rattray JE, Hull AM. Emotional outcome after intensive care: literature review. J Adv Nurs. 2008;64(1):2–13. https://doi.org/10.1111/j.1365-2648.2008.04767.x . Righy C, Rosa RG, da Silva RTA, Kochhann R, Migliavaca CB, Robinson CC, et al. Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis. Crit Care. 2019;23(1):213. https://doi.org/10.1186/s13054-019-2489-3 . Wade DM, Mouncey PR, Richards-Belle A, Wulff J, Harrison DA, Sadique MZ, et al. Effect of a nurse-led preventive psychological intervention on symptoms of posttraumatic Stress disorder among critically ill patients: A randomized clinical trial. JAMA. 2019;321(7):665–75. https://doi.org/10.1001/jama.2019.0073 . Hiser SL, Fatima A, Ali M, Needham DM. Post-intensive care syndrome (PICS): recent updates. J Intensive Care. 2023;11(1):23. https://doi.org/10.1186/s40560-023-00670-7 . Geense WW, Zegers M, Peters MAA, Ewalds E, Simons KS, Vermeulen H, et al. New physical, mental, and cognitive problems 1 year after ICU admission: A prospective multicenter study. Am J Respir Crit Care Med. 2021;203(12):1512–21. https://doi.org/10.1164/rccm.202009-3381OC . Lee M, Kang J, Jeong YJ. Risk factors for post-intensive care syndrome: A systematic review and meta-analysis. Aust Crit Care. 2020;33(3):287–94. https://doi.org/10.1016/j.aucc.2019.10.004 . Hong J, Kang J. Development and validation of a patient version of person-centered critical care nursing questionnaire: A methodological study. SAGE Open. 2020;10(2). https://doi.org/10.1177/2158244020924423 . Mitchell ML, Coyer F, Kean S, Stone R, Murfield J, Dwan T. Patient, family-centred care interventions within the adult ICU setting: An integrative review. Aust Crit Care. 2016;29(4):179–93. https://doi.org/10.1016/j.aucc.2016.08.002 . Kleinpell R, Zimmerman J, Vermoch KL, Harmon LA, Vondracek H, Hamilton R, et al. Promoting family engagement in the ICU: Experience from a national collaborative of 63 ICUs. Crit Care Med. 2019;47(12):1692–8. https://doi.org/10.1097/CCM.0000000000004009 . Vincent JL, Shehabi Y, Walsh TS, Pandharipande PP, Ball JA, Spronk P, et al. Comfort and patient-centred care without excessive sedation: the eCASH concept. Intensive Care Med. 2016;42(6):962–71. https://doi.org/10.1007/s00134-016-4297-4 . Hong HJ, Kang J. A qualitative content analysis of the person-centered care experienced by critical care patients. J Korean Crit Care Nur. 2018;11(2):21–33. Goldfarb MJ, Bibas L, Bartlett V, Jones H, Khan N. Outcomes of patient- and family-centered care interventions in the ICU: A systematic review and meta-analysis. Crit Care Med. 2017;45(10):1751–61. https://doi.org/10.1097/CCM.0000000000002624 . Anna S, Catharina F, Ann-Charlotte F. The core of patient-participation in the Intensive Care Unit: The patient's views. Intensive Crit Care Nurs. 2022;68:103119. https://doi.org/10.1016/j.iccn.2021.103119 . Kang J, Cho YS. Cross-cultural validation of the intensive care experience questionnaire in Korean critical care survivors. Asian Nurs Res. 2020;14(2):89–96. https://doi.org/10.1016/j.anr.2020.03.002 . Rattray J, Johnston M, Wildsmith JA. The intensive care experience: development of the ICE questionnaire. J Adv Nurs. 2004;47(1):64–73. https://doi.org/10.1111/j.1365-2648.2004.03066.x . Jeong YJ, Kang J. Development and validation of a questionnaire to measure post-intensive care syndrome. Intensive Crit Care Nurs. 2019;55:102756. https://doi.org/10.1016/j.iccn.2019.102756 . Rattray J, Crocker C, Jones M, Connaghan J. Patients' perceptions of and emotional outcome after intensive care: results from a multicentre study. Nurs Crit Care. 2010;15(2):86–93. https://doi.org/10.1111/j.1478-5153.2010.00387.x . Kang J, Lee M, Cho YS, Jeong JH, Choi SA, Hong J. The relationship between person-centred care and the intensive care unit experience of critically ill patients: A multicentre cross-sectional survey. Aust Crit Care. 2022;35(6):623–9. https://doi.org/10.1016/j.aucc.2021.10.010 . Jung J, Jang S, Jo S, Lee S. Delirium experience of the intensive care unit patients. J Korean Acad Nurs. 2022;52(2):134–43. https://doi.org/10.4040/jkan.21240 . Bohart S, Møller AM, Andreasen AS, Waldau T, Lamprecht C, Thomsen T. Effect of patient and family centred care interventions for adult intensive care unit patients and their families: A systematic review and meta-analysis. Intensive Crit Care Nurs. 2022;69:103156. https://doi.org/10.1016/j.iccn.2021.103156 . Cabrini L, Landoni G, Antonelli M, Bellomo R, Colombo S, Negro A, et al. Critical care in the near future: patient-centered, beyond space and time boundaries. Minerva anestesiol. 2016;82(5):599–604. Cortés-Beringola A, Vicent L, Martín-Asenjo R, Puerto E, Domínguez-Pérez L, Maruri R, et al. Diagnosis, prevention, and management of delirium in the intensive cardiac care unit. Am Heart J. 2021;232:164–76. https://doi.org/10.1016/j.ahj.2020.11.011 . Kang J, Cho YS, Lee M, Yun S, Jeong YJ, Won YH, et al. Effects of nonpharmacological interventions on sleep improvement and delirium prevention in critically ill patients: A systematic review and meta-analysis. Aust Crit Care. 2023;36(4):640–9. https://doi.org/10.1016/j.aucc.2022.04.006 . Renckens SC, Pasman HR, Klop HT, du Perron C, van Zuylen L, Steegers MAH, et al. Support for relatives in the intensive care unit: Lessons from a cross-sectional multicentre cohort study during the COVID-19 pandemic. BMC Health Serv Res. 2023;23(1):763. https://doi.org/10.1186/s12913-023-09756-2 . Rose L, Yu L, Casey J, Cook A, Metaxa V, Pattison N, et al. Communication and virtual visiting for families of patients in intensive care during the COVID-19 Pandemic: A UK national survey. Ann Am Thorac Soc. 2021;18(10):1685–92. https://doi.org/10.1513/AnnalsATS.202012-1500OC . Brown SM, Bose S, Banner-Goodspeed V, Beesley SJ, Dinglas VD, Hopkins RO. Approaches to addressing post-Intensive care syndrome among intensive care unit survivors. A narrative review. Ann Am Thorac Soc. 2019;16(8):947–56. https://doi.org/10.1513/AnnalsATS.201812-913FR . Boehm LM, Danesh V, Eaton TL, McPeake J, Pena MA, Bonnet KR, et al. Multidisciplinary ICU recovery clinic visits: A qualitative analysis of patient-provider dialogues. Chest. 2023;163(4):843–54. https://doi.org/10.1016/j.chest.2022.10.001 . van Sleeuwen D, van de Laar FA, Simons K, van Bommel D, Burgers-Bonthuis D, Koeter J, et al. MiCare study, an evaluation of structured, multidisciplinary and personalised post-ICU care on physical and psychological functioning, and quality of life of former ICU patients: a study protocol of a stepped-wedge cluster randomised controlled trial. BMJ open. 2022;12(9):e059634. https://doi.org/10.1136/bmjopen-2021-059634 . Kwon BS. Rehabilitation medicine healthcare supply and delivery system. J Korean Med Assoc. 2017;60(11):860–3. https://doi.org/10.5124/jkma.2017.60.11.860 . Geense WW, Zegers M, Peters MAA, Ewalds E, Simons KS, Vermeulen H, et al. New physical, mental, and cognitive problems 1 year after ICU admission: A prospective multicenter study. Am J Respir Crit Care Med. 2021;203(12):1512–21. https://doi.org/10.1164/rccm.202009-3381OC . Marra A, Pandharipande PP, Girard TD, Patel MB, Hughes CG, Jackson JC, et al. Co-occurrence of post-intensive care syndrome problems among 406 survivors of critical illness. Crit Care Med. 2018;46(9):1393–401. https://doi.org/10.1097/CCM.0000000000003218 . Ramnarain D, Aupers E, den Oudsten B, Oldenbeuving A, de Vries J, Pouwels S. Post intensive care syndrome (PICS): an overview of the definition, etiology, risk factors, and possible counseling and treatment strategies. Expert Rev Neurother. 2021;21(10):1159–77. https://doi.org/10.1080/14737175.2021.1981289 . Falvey JR, Cohen AB, O'Leary JR, Leo-Summers L, Murphy TE, Ferrante LE. Association of social isolation with disability burden and 1-year mortality among older adults with critical illness. JAMA Intern Med. 2021;181(11):1433–9. https://doi:10.1001/jamainternmed.2021.5022 . Additional Declarations No competing interests reported. Supplementary Files Supplementaryfile.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4263750","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":294079122,"identity":"bb00054a-efcb-45ee-ae2b-68e88b9a3aab","order_by":0,"name":"Jiyeon Kang","email":"","orcid":"","institution":"Dong-A University","correspondingAuthor":false,"prefix":"","firstName":"Jiyeon","middleName":"","lastName":"Kang","suffix":""},{"id":294079123,"identity":"9138c7c7-6605-42d5-a19d-e1ce5a5d3be9","order_by":1,"name":"Seonyoung Yun","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAtklEQVRIiWNgGAWjYNCCChjjANFazpCshbGNFC3yM3LMpAvnHbY3OMD88APDmXuEtRjcAGqZue1w4oYDbMYSDDeKidAiAdTCu+1wgsEBBjMGhg8JRDqMdw7IYezfiNPCAHIYb8Nhxg0HeIC23CBCi8GZZ8XWPMfSE2ce5imWSDhDjMPakzfe5qmxtuc73r7xw4djxDhMIMMASDYzMDADKWI0MDDwH38AJOuIUjsKRsEoGAUjFAAAEDc45dM2bZoAAAAASUVORK5CYII=","orcid":"","institution":"Youngsan University","correspondingAuthor":true,"prefix":"","firstName":"Seonyoung","middleName":"","lastName":"Yun","suffix":""}],"badges":[],"createdAt":"2024-04-14 05:59:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4263750/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4263750/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":55530080,"identity":"ef6d8933-58d1-44c7-937c-a561f4d77f18","added_by":"auto","created_at":"2024-04-29 15:30:13","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":30912,"visible":true,"origin":"","legend":"\u003cp\u003eEnrolment and follow-up. ICU = intensive care unit.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4263750/v1/b2b0b08111916167285c1c65.png"},{"id":55530081,"identity":"f6b89462-31bf-4ebc-bb20-46f2e762ab82","added_by":"auto","created_at":"2024-04-29 15:30:13","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":72749,"visible":true,"origin":"","legend":"\u003cp\u003eMediating effect of person centred care in the relationship between ICE-frightening and post-intensive care syndrome at 12 months. B = unstandardized estimates; CI = confidence interval; ICE = Intensive care experience; LLCI = lower limit confidence interval; PICS = post-intensive care syndrome; SE = standard error; ULCI = upper limit confidence interval.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4263750/v1/835460604012de4163ff8124.png"},{"id":67156615,"identity":"d2838a2b-c5c4-4455-8b43-8d1c815bd39c","added_by":"auto","created_at":"2024-10-21 18:10:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1174334,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4263750/v1/eb534975-0142-492e-b430-843d776dab20.pdf"},{"id":55530082,"identity":"0df8295d-9902-441f-838b-c1f8641e82cc","added_by":"auto","created_at":"2024-04-29 15:30:13","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":50652,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementaryfile.docx","url":"https://assets-eu.researchsquare.com/files/rs-4263750/v1/f28d4e9ecddce3acd6f2beff.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effects of person-centred care and intensive care experience on post-intensive care syndrome in critical care survivors: a multi-centre prospective cohort study","fulltext":[{"header":"Background","content":"\u003cp\u003eFor the majority of patients and their families, being admitted to the intensive care unit (ICU) is a significant and unexpected occurrence. Regardless of diagnosis or disease severity, ICU patients suffer from physical and emotional distress including sleep deprivation, pain, annoyance from tubes and lines, thirst, isolation, anxiety and fear, embarrassment and lack of information [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Some patients characterise their experience with intensive care as \u0026lsquo;unrealistic\u0026rsquo; or \u0026lsquo;inhumane\u0026rsquo; [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Additionally, more than half of ICU patients may develop delirium, an acute brain dysfunction characterised by altered consciousness and behaviour [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Due to these negative experiences, the incidence of posttraumatic stress disorder (PTSD) among ICU patients reaches 20%, and their PTSD may persist long after being discharged [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eICU survivors experience various aftereffects, and the health challenges they face are called post-intensive care syndrome (PICS) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Among 2,345 survivors in the Netherlands, 43\u0026ndash;58% experienced new-onset PICS after ICU admission [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In a comprehensive meta-analysis, age, female gender, previous mental health problems, disease severity, delirium and negative ICU experience were reported as risk factors that significantly increased the incidence of PICS. The last two of those can be considered modifiable and nursing-sensitive factors [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Delirium and a negative intensive care experience (ICE) are related, and strategies to address them are consistent with recent advances in person-centred care (PCC) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePCC is professional care that respects patients as unique individuals while providing empathy, communication, advocacy and comfort [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. It is also called patient- and family-centred care (PFCC) in the ICU [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Various types of interventions, including early comfort, sleep promotion, appropriate communication, family engagement and palliative care, have been proposed as PCC for critically ill patients [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. According to relevant qualitative studies, PCC has the potential to enhance the ICE of patients [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. PCC interventions are also associated with patient and family satisfaction and may improve their mental health or reduce resource utilisation in the ICU [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePCC provision in the ICU is challenging. One of the most important parts of PCC is patient participation, but it's hard to do in the ICU because of the severity of the patient\u0026rsquo;s disease. As a result, there are few studies on how shared decision-making or empowerment strategies can improve patient outcomes [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Additionally, empirical studies on PCC are limited due to the broad and comprehensive nature of the concept. To date, the majority of related studies have only reported the effects of individual PCC interventions, and there is a dearth of empirical research and evidence on PCC as a holistic concept and its long-term effects. Consequently, the purpose of this study was to investigate the effect of patients' perceived level of PCC and their ICE on PICS, the long-term outcome of critical care.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eDesign\u003c/h2\u003e \u003cp\u003eThis was a second-year study of a multi-centre cohort project on PICS and associated risk factors in ICU survivors. We adopted a longitudinal study design to determine the impact of PCC and ICE on survivors' PICS after discharge. The study findings on the relationship between PCC and ICE, which was the subject of the first year of this initiative, have been published elsewhere (blinded for review). The study protocol was registered with the Korean Clinical Research Information Service (#KCT0004045; date of registration: June 11, 2019; date of 1st participant recruitment: June 7, 2019).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eSetting and Sample\u003c/h2\u003e \u003cp\u003eThis study was conducted in 19 adult ICUs at four university hospitals located in Busan, South Korea. The size of the participating hospitals was 812-1,205 beds. We included 618 patients who were admitted to one of the ICU between May 2019 and July 2020 and met the following criteria: (1) age over 18 years, (2) ICU stay longer than 24 hours, and (3) those who responded at least once to the follow-up surveys conducted 3, 6 and 12 months after discharge. The exclusion criteria were patients who (1) had been admitted to the ICU within the past year, (2) had been diagnosed with a physical disability or mental health problem prior to ICU admission, or (3) whose cognitive limitations prevented them from responding to the questionnaire.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eMeasurements\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003ePatient-centred care\u003c/h2\u003e \u003cp\u003eWe assessed participants\u0026rsquo; perceptions of PCC using the Person-Centered Critical Care Nursing-Patient Version Questionnaire, which was developed and validated by Hong and Kang [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The questionnaire consists of 20 items and five factors: compassion, expertise, communication, comfort and respect. Items are responded to using a 4-point Likert scale. The higher the total score, the more patients perceive that the care they received was person-centred. Hong and Kang [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] reported a Cronbach\u0026rsquo;s alpha of .93. Cronbach\u0026rsquo;s alpha in the present study was .90.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003eIntensive care experience\u003c/h2\u003e \u003cp\u003eThe Korean version of the Intensive Care Experience Questionnaire (K-ICEQ) was used to measure participants\u0026rsquo; ICE [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. This tool was a cultural adaptation and validation of the original ICEQ [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] developed in the United Kingdom to suit the Korean context. The questionnaire has 26 items that are responded to using a 5-point Likert scale and comprises four subscales: Awareness of Surroundings (ICE-Awareness), Frightening Experiences (ICE-Frightening), Satisfaction with Care (ICE-Satisfaction) and Recall of Experiences (ICE-Recall). Scores are calculated for each subscale. The ICE-Awareness score ranges from 8 to 40, and a higher score indicates that the patient was well aware of the people, surroundings and circumstances in the ICU. The score for ICE-Frightening ranges from 9 to 45, with higher scores indicating that the ICU experience was shocking and traumatic. The score range for ICE-Satisfaction is 5\u0026ndash;25, and a higher score means that the evaluation of the treatment and nursing received during the ICU stay was more favourable. The score range for ICE-Recall is 4\u0026ndash;20, and a higher score indicates that the patient recalls the ICU experience without any distortion, reduction or processing. Kang and Cho [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] reported the following Cronbach's alpha coefficients: ICE-Awareness\u0026thinsp;=\u0026thinsp;.93, ICE-Frightening\u0026thinsp;=\u0026thinsp;.80, ICE-Satisfaction\u0026thinsp;=\u0026thinsp;.74 and ICE-Recall\u0026thinsp;=\u0026thinsp;.76. In our study, Cronbach's alphas were .79, .79, .68 and .48, respectively.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003ePost-intensive care syndrome\u003c/h2\u003e \u003cp\u003eWe measured participants' PICS with the Post-Intensive Care Syndrome Questionnaire developed and validated by Jeong and Kang [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The questionnaire has 18 items that are responded to using a 4-point Likert scale and comprises three factors: physical, mental and cognitive problems. Total scores range from 0\u0026ndash;54, and the higher the score, the more severe the PICS. Jeong and Kang [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] reported a Cronbach\u0026rsquo;s alpha of .93. In the present study, Cronbach\u0026rsquo;s alphas at 3, 6 and 12 months after discharge were .90, .89 and .89, respectively.\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003e The Institutional Review Boards of X University and the four participating hospitals approved this study (2-1040709-AB-N-01-201904-HR-021-06, H-1907-015-080, 19\u0026ndash;0096, KUGH 2019-05-014-002). We publicly recruited participants by posting notices about the study in the ICUs. We thoroughly explained the purpose and methods of the study, the confidentiality of personal information, and the voluntary nature of participation to ensure participants\u0026rsquo; understanding. All participants provided written informed consent for the study.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eProcedure\u003c/h2\u003e \u003cp\u003eData collection was conducted in two phases: pre- and post-hospital discharge. The first phase of the survey was conducted in the patient\u0026rsquo;s room or lounge within a week after the participants were moved from the ICU to the general ward. Completing the questionnaire took 10 to 15 minutes. The PCC and ICE measures had to be completed by the participants independently. If this proved to be too difficult, a research assistant read the questionnaire to the participant and filled in their responses. Data on disease and treatment-related characteristics were extracted from the electronic medical records.\u003c/p\u003e \u003cp\u003eThe second phase of data collection was the PICS assessment, which was conducted at 3, 6 and 12 months after hospital discharge. Initially, the survey was administered face-to-face to participants during their follow-up visits to the hospital. However, as of March 2020, all surveys were conducted via telephone due to the coronavirus disease (COVID-19) pandemic. The survey was executed in adherence to a clearly established protocol by a group of five research assistants. To mitigate discrepancies among the research assistants, regular seminars and training sessions were organised.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eWe used IBM SPSS Statistics version 26.0 (IBM Corp.; Armonk, NY) to analyse the data. Descriptive statistics were calculated for the demographic characteristics, treatment-related characteristics, PCC, ICE and PICS as frequencies, percentages, means and standard deviations. A standard score was computed to assess the severity of the disease, given that the instrument used by each hospital varied, specifically either acute physiology and chronic health evaluation II (APACHE II) or Simplified acute physiologic score 3 (SAPS 3). We analysed differences in PICS according to participant characteristics using a t-test and a one-way ANOVA. The correlations between PCC, ICE and PICS were analysed using Pearson\u0026rsquo;s correlation coefficients.\u003c/p\u003e \u003cp\u003eUsing multiple regression, the effects of PCC and ICE on PICS 3, 6 and 12 months after discharge were analysed. We examined multicollinearity and autocorrelation for the assumptions of regression analysis. The variation inflation factor of the regression models varied between 1.12 and 2.36, with values not surpassing 10, and the tolerance ranged from 0.5 to 0.9, with values exceeding 0.1. Consequently, there was no multicollinearity among the independent variables. Additionally, the Durbin-Watson values for each model were near 2 (1.81, 1.92 and 1.85), indicating that autocorrelation was not a concern.\u003c/p\u003e \u003cp\u003eHierarchical regression and path analyses were employed to examine the mediating effect of PCC in the relationship between ICE and PICS. In order to evaluate the significance of the indirect effect, PROCESS macro model 4 was employed, utilising 5,000 bootstrap samples and a 95% confidence interval (CI). Changes in PICS over time were analysed using repeated-measures ANOVA, and Mauchly's test value was .95, which was greater than .05, satisfying the sphericity assumption. We analysed the factors influencing PICS changes over time using the linear mixed model (LMM).\u003c/p\u003e \u003cp\u003eTo reduce bias and maximise statistical power, missing data were imputed. The process of imputation was executed by combining predictive mean matching with multivariate imputation. All statistical significance levels were set at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u0026rsquo; characteristics\u003c/h2\u003e \u003cp\u003eA total of 9,135 patients were admitted to the ICUs during the study period. Of these, 1,652 patients expressed their intention to participate, and among them, 891 who met the inclusion criteria completed the PCC and ICE questionnaires in the first phase of the survey. From the first phase participants, 618 who completed the second phase survey at least once in 3, 6 and 12 months following hospital discharge were included as the final participants for this study (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe average age of the participants was 60.15\u0026thinsp;\u0026plusmn;\u0026thinsp;13.27 years, and 59.7% of them were men. Prior to ICU admission, 57.3% had a functional comorbidity index (FCI)\u0026thinsp;\u0026ge;\u0026thinsp;1, and 14.2% developed delirium in the ICU. Their average ICU stay was 4.65\u0026thinsp;\u0026plusmn;\u0026thinsp;7.79 days, and most (83.8%) participants were discharged to their home. The average PICS scores at 3, 6 and 12 months were statistically significantly different depending on the participants' gender, age, employment, FCI, delirium, length of ICU stay and discharge place (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifferences in post-intensive care syndrome according to characteristics of the participants (N\u0026thinsp;=\u0026thinsp;618)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003cp\u003en (%) or\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"9\" nameend=\"c12\" namest=\"c4\"\u003e \u003cp\u003ePICS\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e3 months\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c9\" namest=\"c7\"\u003e \u003cp\u003e6 months\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c12\" namest=\"c10\"\u003e \u003cp\u003e12 months\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et or F\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003et or F\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003et or F\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e8.81\u0026thinsp;\u0026plusmn;\u0026thinsp;7.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e7.49\u0026thinsp;\u0026plusmn;\u0026thinsp;6.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e11.13\u0026thinsp;\u0026plusmn;\u0026thinsp;7.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e40.91*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMan\u003c/p\u003e \u003cp\u003eWoman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e369 (59.7)\u003c/p\u003e \u003cp\u003e249 (40.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e7.82\u0026thinsp;\u0026plusmn;\u0026thinsp;6.71\u003c/p\u003e \u003cp\u003e10.27\u0026thinsp;\u0026plusmn;\u0026thinsp;8.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-3.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e6.83\u0026thinsp;\u0026plusmn;\u0026thinsp;6.44\u003c/p\u003e \u003cp\u003e8.46\u0026thinsp;\u0026plusmn;\u0026thinsp;6.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e-3.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e10.41\u0026thinsp;\u0026plusmn;\u0026thinsp;7.78\u003c/p\u003e \u003cp\u003e12.20\u0026thinsp;\u0026plusmn;\u0026thinsp;7.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e-2.763\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;60\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.15\u0026thinsp;\u0026plusmn;\u0026thinsp;13.27\u003c/p\u003e \u003cp\u003e268 (43.4)\u003c/p\u003e \u003cp\u003e350 (56.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.40\u0026thinsp;\u0026plusmn;\u0026thinsp;6.67\u003c/p\u003e \u003cp\u003e9.89\u0026thinsp;\u0026plusmn;\u0026thinsp;8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.39\u0026thinsp;\u0026plusmn;\u0026thinsp;6.89\u003c/p\u003e \u003cp\u003e8.32\u0026thinsp;\u0026plusmn;\u0026thinsp;6.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.622\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e9.14\u0026thinsp;\u0026plusmn;\u0026thinsp;7.70\u003c/p\u003e \u003cp\u003e12.66\u0026thinsp;\u0026plusmn;\u0026thinsp;7.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e5.612\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e285 (46.1)\u003c/p\u003e \u003cp\u003e333 (53.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e7.20\u0026thinsp;\u0026plusmn;\u0026thinsp;6.35\u003c/p\u003e \u003cp\u003e10.19\u0026thinsp;\u0026plusmn;\u0026thinsp;8.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-4.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e6.59\u0026thinsp;\u0026plusmn;\u0026thinsp;6.53\u003c/p\u003e \u003cp\u003e8.25\u0026thinsp;\u0026plusmn;\u0026thinsp;6.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e-3.129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e9.41\u0026thinsp;\u0026plusmn;\u0026thinsp;7.15\u003c/p\u003e \u003cp\u003e12.61\u0026thinsp;\u0026plusmn;\u0026thinsp;8.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e-5.111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFCI prior to ICU admission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e264 (42.7)\u003c/p\u003e \u003cp\u003e205 (33.2)\u003c/p\u003e \u003cp\u003e149 (24.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e6.78\u0026thinsp;\u0026plusmn;\u0026thinsp;6.04\u003c/p\u003e \u003cp\u003e8.67\u0026thinsp;\u0026plusmn;\u0026thinsp;7.50\u003c/p\u003e \u003cp\u003e12.60\u0026thinsp;\u0026plusmn;\u0026thinsp;9.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e29.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e6.73\u0026thinsp;\u0026plusmn;\u0026thinsp;6.20\u003c/p\u003e \u003cp\u003e7.00\u0026thinsp;\u0026plusmn;\u0026thinsp;6.27\u003c/p\u003e \u003cp\u003e9.49\u0026thinsp;\u0026plusmn;\u0026thinsp;7.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e9.310\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e9.96\u0026thinsp;\u0026plusmn;\u0026thinsp;7.42\u003c/p\u003e \u003cp\u003e10.66\u0026thinsp;\u0026plusmn;\u0026thinsp;7.79\u003c/p\u003e \u003cp\u003e13.86\u0026thinsp;\u0026plusmn;\u0026thinsp;8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e12.590\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReason for ICU admission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical disease\u003c/p\u003e \u003cp\u003ePostoperative\u003c/p\u003e \u003cp\u003eNeurologic disease\u003c/p\u003e \u003cp\u003eTrauma\u003c/p\u003e \u003cp\u003eCardiovascular disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105 (17.0)\u003c/p\u003e \u003cp\u003e181 (29.3)\u003c/p\u003e \u003cp\u003e166 (26.9)\u003c/p\u003e \u003cp\u003e47 (7.6)\u003c/p\u003e \u003cp\u003e119 (19.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e9.71\u0026thinsp;\u0026plusmn;\u0026thinsp;7.89\u003c/p\u003e \u003cp\u003e7.71\u0026thinsp;\u0026plusmn;\u0026thinsp;6.97\u003c/p\u003e \u003cp\u003e8.72\u0026thinsp;\u0026plusmn;\u0026thinsp;8.05\u003c/p\u003e \u003cp\u003e9.40\u0026thinsp;\u0026plusmn;\u0026thinsp;6.51\u003c/p\u003e \u003cp\u003e9.58\u0026thinsp;\u0026plusmn;\u0026thinsp;8.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e8.71\u0026thinsp;\u0026plusmn;\u0026thinsp;7.24\u003c/p\u003e \u003cp\u003e6.43\u0026thinsp;\u0026plusmn;\u0026thinsp;5.79\u003c/p\u003e \u003cp\u003e7.20\u0026thinsp;\u0026plusmn;\u0026thinsp;7.37\u003c/p\u003e \u003cp\u003e7.77\u0026thinsp;\u0026plusmn;\u0026thinsp;5.31\u003c/p\u003e \u003cp\u003e8.29\u0026thinsp;\u0026plusmn;\u0026thinsp;6.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.600\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e12.03\u0026thinsp;\u0026plusmn;\u0026thinsp;8.44\u003c/p\u003e \u003cp\u003e9.85\u0026thinsp;\u0026plusmn;\u0026thinsp;7.51\u003c/p\u003e \u003cp\u003e10.81\u0026thinsp;\u0026plusmn;\u0026thinsp;7.84\u003c/p\u003e \u003cp\u003e11.94\u0026thinsp;\u0026plusmn;\u0026thinsp;8.12\u003c/p\u003e \u003cp\u003e12.43\u0026thinsp;\u0026plusmn;\u0026thinsp;7.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e2.543\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdmission route\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmergency room\u003c/p\u003e \u003cp\u003eWard\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e321 (51.9)\u003c/p\u003e \u003cp\u003e297 (48.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e9.26\u0026thinsp;\u0026plusmn;\u0026thinsp;8.03\u003c/p\u003e \u003cp\u003e8.33\u0026thinsp;\u0026plusmn;\u0026thinsp;7.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e7.88\u0026thinsp;\u0026plusmn;\u0026thinsp;7.04\u003c/p\u003e \u003cp\u003e7.06\u0026thinsp;\u0026plusmn;\u0026thinsp;6.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.533\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e11.31\u0026thinsp;\u0026plusmn;\u0026thinsp;7.84\u003c/p\u003e \u003cp\u003e10.94\u0026thinsp;\u0026plusmn;\u0026thinsp;7.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.552\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisease severity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAPACHE Ⅱ\u003c/p\u003e \u003cp\u003eSAPS 3\u003c/p\u003e \u003cp\u003eStandardized score\u003c/p\u003e \u003cp\u003e\u0026lt; 0\u003c/p\u003e \u003cp\u003e\u0026ge; 0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.50\u0026thinsp;\u0026plusmn;\u0026thinsp;6.31\u003c/p\u003e \u003cp\u003e34.24\u0026thinsp;\u0026plusmn;\u0026thinsp;16.13\u003c/p\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e \u003cp\u003e313 (50.6)\u003c/p\u003e \u003cp\u003e305 (49.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.36\u0026thinsp;\u0026plusmn;\u0026thinsp;7.94\u003c/p\u003e \u003cp\u003e9.27\u0026thinsp;\u0026plusmn;\u0026thinsp;7.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7.41\u0026thinsp;\u0026plusmn;\u0026thinsp;6.82\u003c/p\u003e \u003cp\u003e10.80\u0026thinsp;\u0026plusmn;\u0026thinsp;7.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.303\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.762\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e10.80\u0026thinsp;\u0026plusmn;\u0026thinsp;7.81\u003c/p\u003e \u003cp\u003e11.48\u0026thinsp;\u0026plusmn;\u0026thinsp;8.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-1.074\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.283\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119 (19.3)\u003c/p\u003e \u003cp\u003e499 (80.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e8.87\u0026thinsp;\u0026plusmn;\u0026thinsp;7.79\u003c/p\u003e \u003cp\u003e8.80\u0026thinsp;\u0026plusmn;\u0026thinsp;7.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.931\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e9.10\u0026thinsp;\u0026plusmn;\u0026thinsp;7.14\u003c/p\u003e \u003cp\u003e7.10\u0026thinsp;\u0026plusmn;\u0026thinsp;6.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.975\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e11.45\u0026thinsp;\u0026plusmn;\u0026thinsp;8.14\u003c/p\u003e \u003cp\u003e11.06\u0026thinsp;\u0026plusmn;\u0026thinsp;7.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.480\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.631\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e338 (54.7)\u003c/p\u003e \u003cp\u003e280 (45.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e8.14\u0026thinsp;\u0026plusmn;\u0026thinsp;7.35\u003c/p\u003e \u003cp\u003e9.63\u0026thinsp;\u0026plusmn;\u0026thinsp;8.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-2.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e7.07\u0026thinsp;\u0026plusmn;\u0026thinsp;6.26\u003c/p\u003e \u003cp\u003e7.99\u0026thinsp;\u0026plusmn;\u0026thinsp;7.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e-1.709\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.088\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e10.81\u0026thinsp;\u0026plusmn;\u0026thinsp;7.87\u003c/p\u003e \u003cp\u003e11.52\u0026thinsp;\u0026plusmn;\u0026thinsp;7.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e-1.103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.271\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelirium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88 (14.2)\u003c/p\u003e \u003cp\u003e530 (85.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e11.81\u0026thinsp;\u0026plusmn;\u0026thinsp;8.12\u003c/p\u003e \u003cp\u003e8.31\u0026thinsp;\u0026plusmn;\u0026thinsp;7.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e11.25\u0026thinsp;\u0026plusmn;\u0026thinsp;7.22\u003c/p\u003e \u003cp\u003e6.86\u0026thinsp;\u0026plusmn;\u0026thinsp;6.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e5.905\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e14.81\u0026thinsp;\u0026plusmn;\u0026thinsp;9.38\u003c/p\u003e \u003cp\u003e10.52\u0026thinsp;\u0026plusmn;\u0026thinsp;7.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e4.791\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICU days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;4\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.65\u0026thinsp;\u0026plusmn;\u0026thinsp;7.79\u003c/p\u003e \u003cp\u003e397 (64.2)\u003c/p\u003e \u003cp\u003e221 (35.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.28\u0026thinsp;\u0026plusmn;\u0026thinsp;7.54\u003c/p\u003e \u003cp\u003e9.76\u0026thinsp;\u0026plusmn;\u0026thinsp;7.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-2.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.91\u0026thinsp;\u0026plusmn;\u0026thinsp;6.42\u003c/p\u003e \u003cp\u003e8.52\u0026thinsp;\u0026plusmn;\u0026thinsp;6.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e-2.840\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e10.35\u0026thinsp;\u0026plusmn;\u0026thinsp;7.62\u003c/p\u003e \u003cp\u003e12.54\u0026thinsp;\u0026plusmn;\u0026thinsp;8.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e-3.325\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDischarge place\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHome\u003c/p\u003e \u003cp\u003eExtended care facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e518 (83.8)\u003c/p\u003e \u003cp\u003e100 (16.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e8.40\u0026thinsp;\u0026plusmn;\u0026thinsp;7.37\u003c/p\u003e \u003cp\u003e10.93\u0026thinsp;\u0026plusmn;\u0026thinsp;9.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e6.85\u0026thinsp;\u0026plusmn;\u0026thinsp;6.13\u003c/p\u003e \u003cp\u003e10.76\u0026thinsp;\u0026plusmn;\u0026thinsp;8.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e-5.519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c10\"\u003e \u003cp\u003e10.74\u0026thinsp;\u0026plusmn;\u0026thinsp;7.75\u003c/p\u003e \u003cp\u003e13.19\u0026thinsp;\u0026plusmn;\u0026thinsp;8.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e-2.859\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003e*Repeated Measures ANOVA on PICS difference over 3, 6, and 12 months. APACHE Ⅱ = acute physiology and chronic health evaluation Ⅱ; FCI\u0026thinsp;=\u0026thinsp;functional comorbidity index; ICU\u0026thinsp;=\u0026thinsp;intensive care unit; PICS\u0026thinsp;=\u0026thinsp;post-intensive care syndrome; SAPS 3\u0026thinsp;=\u0026thinsp;simplified acute physiologic score 3; SD\u0026thinsp;=\u0026thinsp;standard deviation.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eCorrelations between PCC, ICE and PICS\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents the mean scores for PCC and ICE during the patient\u0026rsquo;s ICU stay and PICS at 3, 6 and 12 months after hospital discharge, and the correlations between them. Positive correlations were observed between PCC and ICE-Awareness (r\u0026thinsp;=\u0026thinsp;.37, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and ICE-Satisfaction (r\u0026thinsp;=\u0026thinsp;.57, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Conversely, PCC negatively correlated with ICE-Frightening (r\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.36, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). A positive correlation was observed between PICS at 3 months and ICE-Frightening (r\u0026thinsp;=\u0026thinsp;.14, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001). At 6 months, PICS had a positive correlation with ICE-Frightening (r\u0026thinsp;=\u0026thinsp;.15, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), whereas it negatively correlated with PCC (r\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.11, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.009) and ICE-Awareness (r\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.13, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.002). At 12 months, a negative correlation was observed between PICS and PCC (r\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.15, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), ICE-Awareness (r\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.14, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and ICE-Satisfaction (r\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.09, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.030); however, a positive correlation was found with ICE-Frightening (r\u0026thinsp;=\u0026thinsp;.13, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMeans, standard deviations and correlations for the study variables (N\u0026thinsp;=\u0026thinsp;618)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003cp\u003e(Range)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePCC\u003c/p\u003e \u003cp\u003er (\u003cem\u003eP\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eICE-Awareness\u003c/p\u003e \u003cp\u003er (\u003cem\u003eP\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eICE-Frightening\u003c/p\u003e \u003cp\u003er (\u003cem\u003eP\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eICE-Satisfaction\u003c/p\u003e \u003cp\u003er (\u003cem\u003eP\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eICE-Recall\u003c/p\u003e \u003cp\u003er (\u003cem\u003eP\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePICS-3months\u003c/p\u003e \u003cp\u003er (\u003cem\u003eP\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003ePICS-6months\u003c/p\u003e \u003cp\u003er (\u003cem\u003eP\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003ePICS-12months\u003c/p\u003e \u003cp\u003er (\u003cem\u003eP\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e60.98\u0026thinsp;\u0026plusmn;\u0026thinsp;9.62 (20\u0026ndash;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICE-Awareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e33.05\u0026thinsp;\u0026plusmn;\u0026thinsp;5.36 (8\u0026ndash;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.37 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICE-Frightening\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e16.51\u0026thinsp;\u0026plusmn;\u0026thinsp;5.80 (9\u0026ndash;45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.36 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.19 (.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICE-Satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.52\u0026thinsp;\u0026plusmn;\u0026thinsp;2.64 (5\u0026ndash;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.57 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.24 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.50 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICE-Recall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e14.54\u0026thinsp;\u0026plusmn;\u0026thinsp;2.30 (4\u0026ndash;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.50 (.221)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.23 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.18 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.19 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePICS-3months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e8.81\u0026thinsp;\u0026plusmn;\u0026thinsp;7.72 (0\u0026ndash;54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.06 (.142)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.07 (.070)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.14 (.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.06 (.124)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.07 (.105)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePICS-6months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e7.49\u0026thinsp;\u0026plusmn;\u0026thinsp;6.63 (0\u0026ndash;54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.11 (.009)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.13 (.002)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.15 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.05 (.196)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.03 (.502)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.47 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePICS-12months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e11.13\u0026thinsp;\u0026plusmn;\u0026thinsp;7.91 (0\u0026ndash;54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.15 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.14 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.13 (.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.09 (.030)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.04 (.388)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.33 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.42 (\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eICE\u0026thinsp;=\u0026thinsp;intensive care experience; PCC\u0026thinsp;=\u0026thinsp;patient centred care; PICS\u0026thinsp;=\u0026thinsp;post-intensive care syndrome; SD\u0026thinsp;=\u0026thinsp;standard deviation.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eThe effect of PCC and ICE on PICS 3, 6 and 12 months after ICU discharge\u003c/b\u003e \u003c/p\u003e \u003cp\u003e We conducted multivariate regression analyses at each time point to determine the impact of participants' demographic and clinical characteristics, PCC, and the four ICE dimensions on PICS at 3, 6 and 12 months after hospital discharge. For each regression model, those variables that were statistically significant in the univariate analyses were included as independent variables, and all three regression models were statistically significant.\u003c/p\u003e \u003cp\u003eBeyond the participant characteristics of female gender (β\u0026thinsp;=\u0026thinsp;.16, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), older age (β\u0026thinsp;=\u0026thinsp;.08, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.044), FCI\u0026thinsp;=\u0026thinsp;1 (β\u0026thinsp;=\u0026thinsp;.13, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001), FCI\u0026thinsp;\u0026ge;\u0026thinsp;2 (β\u0026thinsp;=\u0026thinsp;.29, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), delirium (β\u0026thinsp;=\u0026thinsp;.10, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.016) and discharge to an extended care facility (β\u0026thinsp;=\u0026thinsp;.12, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001), ICE-Frightening (β\u0026thinsp;=\u0026thinsp;.09, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.021) was identified as a factor that significantly increased PICS at 3 months after hospital discharge. ICE-Frightening (β\u0026thinsp;=\u0026thinsp;.09, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.032) was also a factor that significantly increased PICS at 6 months, in addition to the participant characteristics of female gender (β\u0026thinsp;=\u0026thinsp;.13, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001), older age (β\u0026thinsp;=\u0026thinsp;.10, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.014), FCI\u0026thinsp;\u0026ge;\u0026thinsp;2 (β\u0026thinsp;=\u0026thinsp;.15, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001), delirium (β\u0026thinsp;=\u0026thinsp;.15, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001) and discharge to an extended care facility (β\u0026thinsp;=\u0026thinsp;.20, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). At 12 months after discharge, female gender (β\u0026thinsp;=\u0026thinsp;.10, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.009), older age (β\u0026thinsp;=\u0026thinsp;.15, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), non-employment (β\u0026thinsp;=\u0026thinsp;.10, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.018), FCI\u0026thinsp;\u0026ge;\u0026thinsp;2 (β\u0026thinsp;=\u0026thinsp;.15, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001), delirium (β\u0026thinsp;=\u0026thinsp;.10, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.024) and discharge to an extended care facility (β\u0026thinsp;=\u0026thinsp;.08, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.044) were factors that increased PICS (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). PCC had no statistically significant effect on PICS at any time point.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEffect of person-centred care and intensive care experience on post-intensive care syndrome (N\u0026thinsp;=\u0026thinsp;618)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"17\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c17\" colnum=\"17\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003ePICS at 3 months\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003ePICS at 6 months\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c17\" namest=\"c12\"\u003e \u003cp\u003ePICS at 12 months\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c15\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c16\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e(Constant)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.414\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e9.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e4.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e1.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.048\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender (ref: male)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e2.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (ref: \u0026lt; 60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e2.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e3.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment (ref: yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e2.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFCI prior to ICU\u003c/p\u003e \u003cp\u003eadmission(=\u0026thinsp;1) (ref: 0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.270\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.268\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFCI prior to ICU\u003c/p\u003e \u003cp\u003eadmission(\u0026ge;\u0026thinsp;2) (ref: 0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e2.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e3.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-1.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeurologic disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.938\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrauma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-1.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e1.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.440\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCardiovascular disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.738\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e1.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdmission route\u003c/p\u003e \u003cp\u003e(ref: ER)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisease severity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilator\u003c/p\u003e \u003cp\u003e(ref: yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.602\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgery (ref: yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.064\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelirium (ref: no)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e2.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e2.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICU days (ref: \u0026lt; 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.771\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.733\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e1.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDischarge place\u003c/p\u003e \u003cp\u003e(ref: home)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e2.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerson-centred care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.866\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-1.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICE- Awareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.455\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-1.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICE- Frightening\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.310\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICE- Satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e.879\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICE- Recall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c17\" namest=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e.181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003e.163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c17\" namest=\"c12\"\u003e \u003cp\u003e.162\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRevised R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e.168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003e.141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c17\" namest=\"c12\"\u003e \u003cp\u003e.139\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e13.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003e7.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c17\" namest=\"c12\"\u003e \u003cp\u003e7.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c17\" namest=\"c12\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDurbin-Watson\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e1.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003e1.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c17\" namest=\"c12\"\u003e \u003cp\u003e1.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"17\"\u003eB\u0026thinsp;=\u0026thinsp;unstandardized estimates; ER\u0026thinsp;=\u0026thinsp;emergency room; FCI\u0026thinsp;=\u0026thinsp;functional comorbidity index; ICE\u0026thinsp;=\u0026thinsp;intensive care experience; ICU\u0026thinsp;=\u0026thinsp;intensive care unit; PICS\u0026thinsp;=\u0026thinsp;post-intensive care syndrome; SE\u0026thinsp;=\u0026thinsp;standard error.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eGiven that PCC did not exhibit a statistically significant association with PICS across all three regression models, we examined the mediating effect of PCC in the association between ICE-Frightening and PICS. The results indicated PCC partially mediated the association between ICE-Frightening and PICS at 12 months (B\u0026thinsp;=\u0026thinsp;.06, 95% CI [.01, .11]). Alternatively stated, PCC mitigated the adverse impact of ICE-Frightening on PICS (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The mediating effect of PCC was not statistically significant at 3 months or at 6 months (Supplementary Table\u0026nbsp;1).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e\u003cb\u003eFactors influencing changes in PICS over time\u003c/b\u003e\u003c/h2\u003e \u003cp\u003eAt 3, 6 and 12 months following hospital discharge, the PICS scores of the participants were 8.81\u0026thinsp;\u0026plusmn;\u0026thinsp;7.72, 7.49\u0026thinsp;\u0026plusmn;\u0026thinsp;6.63 and 11.13\u0026thinsp;\u0026plusmn;\u0026thinsp;7.91, respectively; this change was statistically significant (F\u0026thinsp;=\u0026thinsp;40.91, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The LMM analysis of the factors influencing PICS changes over time revealed that only the FCI and discharge place were statistically significant in relation to participant characteristics, PCC and ICE (Supplementary Table\u0026nbsp;2). PICS changes were significantly greater for those discharged to an extended care facility (t\u0026thinsp;=\u0026thinsp;4.81, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and those with a FCI\u0026thinsp;\u0026ge;\u0026thinsp;2 (t = -2.79, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.005) (Supplementary Fig.\u0026nbsp;1).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eWe observed that patients\u0026rsquo; ICE-Frightening during their stay in an ICU were a risk factor for developing PICS 3 and 6 months after hospital discharge, based on a prospective cohort study of 618 survivors. Although PCC was not identified as a statistically significant protective factor against PICS, it partially mediated the association between ICE-Frightening and PICS at 12 months. Significant change occurred in the PICS of survivors over a period of one year; comorbidities prior to admission and discharge place were influential factors in this change.\u003c/p\u003e \u003cp\u003eOf the four dimensions of the ICE that we investigated, only ICE-Frightening was found to significantly worsen PICS. Frightening experience, which includes pain, embarrassment, bad dreams, helplessness and fear of death in the ICU, has been shown to be associated with anxiety, depression and PTSD in survivors after discharge, but empirical evidence on its long-term effects is limited [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This study is significant in that we observed that adverse ICU experiences, such as frightening experiences, can negatively impact survivors' long-term health outcomes after hospital discharge. One of the risk factors that contributes to a negative experience in the ICU is delirium [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], and the distinction between the two is often difficult to discern. Indeed, survivors who had delirium during their ICU stay described being \u0026lsquo;overwhelmed by fear\u0026rsquo; as their most intense experience [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Delirium was a contributing factor to the exacerbation of PICS after discharge in our study. Survivors who experienced delirium exhibited a significantly higher PICS score at all time points. This result aligns with a previous meta-analysis study [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], which reported that adverse experiences and delirium in the ICU were contributors to the deterioration of survivors' mental health and cognitive functions. Considering the above, it appears that enhancing the ICE, which includes delirium prevention, may result in the prevention or alleviation of PICS in survivors.\u003c/p\u003e \u003cp\u003eAt 12 months post-discharge from the ICU, PCC partially mediated the relationship between ICE-Frightening and PICS. This result is intriguing because it demonstrates that interventions targeting PCC can mitigate the adverse effects of ICE-frightening and prevent or reduce PICS even further. Recently, PCC or PFCC as a strategy to improve the ICU experience has received research attention [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], and our findings provide evidence of the importance of PCC for intensive care patients. PCC or PFCC interventions promote patient and family participation in care while recognising the distinctive needs of each individual [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The interventions also include environmental factors in the ICU, such as lighting and noise management [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Kang et al.\u0026rsquo;s [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] meta-analysis identified family participation, information provision, lighting and noise blocking as effective in preventing delirium, which can all be classified as PCC interventions. Recent studies [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] have reported that virtual visiting or video calling to replace visiting restrictions during the COVID-19 pandemic was effective in preventing delirium and reducing psychological distress in ICU patients. Despite these encouraging outcomes, a meta-analysis found insufficient evidence of significant effects of PCC interventions on post-discharge mental health and ICU delirium [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. This finding might be due to the particular PCC interventions\u0026mdash;for example, information sharing and ICU diaries\u0026mdash;that were included in the meta-analysis. Despite the emphasis on the importance of PCC interventions in the ICU, the variety and extent of these interventions restricts their availability and assessment. It is necessary to develop PCC interventions as protocols or bundles to facilitate their implementation by clinicians, including ICU nurses.\u003c/p\u003e \u003cp\u003eIn our study, discharge place was a major influencing factor for PICS. Survivors discharged to an extended care facility had more severe PICS. For ICU survivors, an early post-discharge recovery phase is crucial, and poor rehabilitation during this period is associated with a negative outcome [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Leading Western countries are implementing transition programmes and post-ICU clinics to facilitate the rehabilitation of survivors [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. An increasing number of extended care facilities, including nursing homes and rehabilitation hospitals, are proliferating in Korea due to the country's rapidly ageing population; however, the infrastructure, personnel and insurance payment system required to deliver professional rehabilitation in extended care facilities remain underdeveloped [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Limited infrastructure for post-ICU rehabilitation may not be an issue exclusive to Korea. To enhance long-term outcomes for ICU survivors through rehabilitation continuity, links must be established with acute hospitals and extended care facility that are suitable for each country.\u003c/p\u003e \u003cp\u003eFemale gender, old age and comorbidity were patient-related risk factors that consistently increased PICS over the 12-month period. This result is consistent with findings reported in prior studies [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Among these, comorbidities prior to ICU admission are emphasised as strong risk factors for long-term health outcomes in survivors [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Our results of the LMM analysis showed that survivors with a greater number of comorbidities prior to admission had a smaller effect on PICS changes over the 12 months. The findings indicate that participants with comorbidities maintained a consistently high PICS score, whereas those without comorbidities experienced a statistically significant increase in score from low levels at 3 months to 12 months. ICU nurses must be aware of patient-related factors, particularly comorbidities, as critical characteristics that can be used to proactively identify PICS risk.\u003c/p\u003e \u003cp\u003eThe prevalence and duration of PICS vary among survivors, but the severity generally tends to decrease over time [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. The PICS scores of our participants showed a decline from 3 to 6 months, then an increase from 6 to 12 months. One of the reasons for this V-shaped trajectory could be the COVID-19 pandemic situation during the study period. The pandemic inevitably caused social isolation, and this isolation was closely related to the risk of disability and mortality in ICU survivors [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. During the post-discharge recovery period, it is reasonable to presume that the daily activities and social interactions of our participants were also restricted. Furthermore, the reason for the greatest PICS scores in the mental domain among our participants can be understood within the same context.\u003c/p\u003e \u003cp\u003eThis study is significant for the following reasons. First, we established a multi-centre cohort of the general ICU population and conducted follow-up studies, which increased the generalizability of the results. Second, by examining the long-term effects of PCC and ICE, which are nursing-sensitive factors, we contributed to building evidence for the development of critical care nursing interventions. Lastly, this study used a single instrument that integrated the physical, mental and cognitive domains for assessing PICS, which is in contrast to prior studies that reported only select domains or used separate instruments for each domain. In addition to providing participants with convenience, the use of integrated tools can broaden the scope of the analysis.\u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThis study has several limitations. First, the reliability of the ICE-Recall subscale of the K-ICEQ was low. Unlike previous studies [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], we implemented the use of this subscale immediately after ICU discharge, which may not have been an appropriate time to measure recall. Given that the K-ICEQ is a tool that assigns scores to each subscale, we suggest future studies choose and utilise specific subscales based on the measurement concept and timing. The participants in our study were survivors who completed questionnaires within the general population of ICU patients, indicating that their disease severity was rather low. It is important to consider this when expanding our findings to patients with more severe diseases like sepsis or respiratory failure. Lastly, although all participants were non-COVID-19 patients, the COVID-19 pandemic during the study period may have had an impact on the PICS of participants; thus, the pandemic should be taken into consideration when interpreting the findings.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn this multi-centre cohort study, survivors discharged from 19 ICUs were followed-up for 12 months on their PICS and influencing factors. Survivors' ICE-Frightening in the ICU was a statistically significant risk factor for PICS 3 and 6 months after discharge. Comorbidities, delirium, female gender, advanced age and discharge to an extended care facility were factors that increased PICS consistently over a 12-month period. Furthermore, PCC partially mediated the relationship between ICE-Frightening and PICS. Our findings provide empirical support for the assumption that negative experiences in the ICU should be managed to prevent or alleviate PICS in survivors. Enhancing the long-term prognoses of survivors requires the development and evaluation of PCC interventions that are specifically applicable to the ICU.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eICU \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Intensive care unit\u003c/p\u003e\n\u003cp\u003ePTSD \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Posttraumatic stress disorder\u003c/p\u003e\n\u003cp\u003ePICS \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Post-intensive care syndrome\u003c/p\u003e\n\u003cp\u003eICE \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Intensive care experience\u003c/p\u003e\n\u003cp\u003ePCC \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Person-centred care\u003c/p\u003e\n\u003cp\u003ePFCC \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Patient- and family-centred care\u003c/p\u003e\n\u003cp\u003eK-ICQ \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Korean version of the Intensive Care Experience Questionnaire\u003c/p\u003e\n\u003cp\u003eICE-Awareness \u0026nbsp; \u0026nbsp;Awareness of Surroundings\u003c/p\u003e\n\u003cp\u003eICE-Frightening \u0026nbsp; Frightening Experiences\u003c/p\u003e\n\u003cp\u003eICE-Satisfaction \u0026nbsp; Satisfaction with Care\u003c/p\u003e\n\u003cp\u003eICE-Recall \u0026nbsp; \u0026nbsp; \u0026nbsp; Recall of Experiences\u003c/p\u003e\n\u003cp\u003eCOVID-19 \u0026nbsp; \u0026nbsp; \u0026nbsp; Coronavirus disease\u003c/p\u003e\n\u003cp\u003eAPACHE Ⅱ \u0026nbsp; \u0026nbsp; \u0026nbsp; Acute physiology and chronic health evaluation Ⅱ\u003c/p\u003e\n\u003cp\u003eSAPS 3 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Simplified acute physiologic score 3\u003c/p\u003e\n\u003cp\u003eCI \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Confidence interval\u003c/p\u003e\n\u003cp\u003eLMM \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Linear mixed model\u003c/p\u003e\n\u003cp\u003eFCI \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Functional comorbidity index\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eA\u003c/strong\u003e\u003cstrong\u003euthor\u003c/strong\u003e\u003cstrong\u003es\u0026rsquo;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;contribution\u003c/strong\u003e\u003cstrong\u003es\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJK:\u0026nbsp;Conceptualization, Funding acquisition, Methodology, Supervision, Writing \u0026ndash; original draft, Writing \u0026ndash; review and editing.\u0026nbsp;SY: Formal analysis,\u0026nbsp;Writing \u0026ndash; original draft, Writing \u0026ndash; review and editing. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by the National Research Foundation of Korea (NRF) grant funded by Korea government (MSIT) (no. NRF-2019R1A2C1011300, NRF-2022R1A2C1011917). The funding source had no role in the study design, analysis, data interpretation, or decision to submit for publication.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki and was part of a multi-centre cohort project.\u0026nbsp;The Institutional Review Boards of X University and the four participating hospitals approved this study\u0026nbsp;(2-1040709-AB-N-01-201904-HR-021-06, H-1907-015-080, 19-0096, KUGH 2019-05-014-002). We thoroughly explained the purpose and methods of the study, the confidentiality of personal information, and the voluntary nature of participation to ensure participants\u0026rsquo; understanding. All participants provided written informed consent for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eC\u003c/strong\u003e\u003cstrong\u003eompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLatour JM, Kentish-Barnes N, Jacques T, Wysocki M, Azoulay E, Metaxa V. Improving the intensive care experience from the perspectives of different stakeholders. Crit Care. 2022;26(1):218. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1186/s13054-022-04094-x\u003c/span\u003e\u003cspan address=\"https://doi:10.1186/s13054-022-04094-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKang J, Jeong YJ. Embracing the new vulnerable self: A grounded theory approach on critical care survivors' post-intensive care syndrome. Intensive Crit Care Nurs. 2018;49:44\u0026ndash;50. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.iccn.2018.08.004\u003c/span\u003e\u003cspan address=\"10.1016/j.iccn.2018.08.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlsen KD, Nester M, Hansen BS. Evaluating the past to improve the future - A qualitative study of ICU patients' experiences. Intensive Crit Care Nurs. 2017;43:61\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.iccn.2017.06.008\u003c/span\u003e\u003cspan address=\"10.1016/j.iccn.2017.06.008\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDevlin JW, Skrobik Y, G\u0026eacute;linas C, Needham DM, Slooter AJC, Pandharipande P, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46(9):e825\u0026ndash;73. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/CCM.0000000000003299\u003c/span\u003e\u003cspan address=\"10.1097/CCM.0000000000003299\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePun BT, Badenes R, Heras La Calle G, Orun OM, Chen W, Raman R, et al. Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort study. Lancet Respir Med. 2021;9(3):239\u0026ndash;50. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/S2213-2600(20)30552-X\u003c/span\u003e\u003cspan address=\"10.1016/S2213-2600(20)30552-X\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRattray JE, Hull AM. Emotional outcome after intensive care: literature review. J Adv Nurs. 2008;64(1):2\u0026ndash;13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/j.1365-2648.2008.04767.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1365-2648.2008.04767.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRighy C, Rosa RG, da Silva RTA, Kochhann R, Migliavaca CB, Robinson CC, et al. Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis. Crit Care. 2019;23(1):213. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s13054-019-2489-3\u003c/span\u003e\u003cspan address=\"10.1186/s13054-019-2489-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWade DM, Mouncey PR, Richards-Belle A, Wulff J, Harrison DA, Sadique MZ, et al. Effect of a nurse-led preventive psychological intervention on symptoms of posttraumatic Stress disorder among critically ill patients: A randomized clinical trial. JAMA. 2019;321(7):665\u0026ndash;75. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1001/jama.2019.0073\u003c/span\u003e\u003cspan address=\"10.1001/jama.2019.0073\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHiser SL, Fatima A, Ali M, Needham DM. Post-intensive care syndrome (PICS): recent updates. J Intensive Care. 2023;11(1):23. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s40560-023-00670-7\u003c/span\u003e\u003cspan address=\"10.1186/s40560-023-00670-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGeense WW, Zegers M, Peters MAA, Ewalds E, Simons KS, Vermeulen H, et al. New physical, mental, and cognitive problems 1 year after ICU admission: A prospective multicenter study. Am J Respir Crit Care Med. 2021;203(12):1512\u0026ndash;21. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1164/rccm.202009-3381OC\u003c/span\u003e\u003cspan address=\"10.1164/rccm.202009-3381OC\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee M, Kang J, Jeong YJ. Risk factors for post-intensive care syndrome: A systematic review and meta-analysis. Aust Crit Care. 2020;33(3):287\u0026ndash;94. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.aucc.2019.10.004\u003c/span\u003e\u003cspan address=\"10.1016/j.aucc.2019.10.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHong J, Kang J. Development and validation of a patient version of person-centered critical care nursing questionnaire: A methodological study. SAGE Open. 2020;10(2). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/2158244020924423\u003c/span\u003e\u003cspan address=\"10.1177/2158244020924423\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMitchell ML, Coyer F, Kean S, Stone R, Murfield J, Dwan T. Patient, family-centred care interventions within the adult ICU setting: An integrative review. Aust Crit Care. 2016;29(4):179\u0026ndash;93. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.aucc.2016.08.002\u003c/span\u003e\u003cspan address=\"10.1016/j.aucc.2016.08.002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKleinpell R, Zimmerman J, Vermoch KL, Harmon LA, Vondracek H, Hamilton R, et al. Promoting family engagement in the ICU: Experience from a national collaborative of 63 ICUs. Crit Care Med. 2019;47(12):1692\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/CCM.0000000000004009\u003c/span\u003e\u003cspan address=\"10.1097/CCM.0000000000004009\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVincent JL, Shehabi Y, Walsh TS, Pandharipande PP, Ball JA, Spronk P, et al. Comfort and patient-centred care without excessive sedation: the eCASH concept. Intensive Care Med. 2016;42(6):962\u0026ndash;71. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s00134-016-4297-4\u003c/span\u003e\u003cspan address=\"10.1007/s00134-016-4297-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHong HJ, Kang J. A qualitative content analysis of the person-centered care experienced by critical care patients. J Korean Crit Care Nur. 2018;11(2):21\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoldfarb MJ, Bibas L, Bartlett V, Jones H, Khan N. Outcomes of patient- and family-centered care interventions in the ICU: A systematic review and meta-analysis. Crit Care Med. 2017;45(10):1751\u0026ndash;61. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/CCM.0000000000002624\u003c/span\u003e\u003cspan address=\"10.1097/CCM.0000000000002624\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnna S, Catharina F, Ann-Charlotte F. The core of patient-participation in the Intensive Care Unit: The patient's views. Intensive Crit Care Nurs. 2022;68:103119. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.iccn.2021.103119\u003c/span\u003e\u003cspan address=\"10.1016/j.iccn.2021.103119\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKang J, Cho YS. Cross-cultural validation of the intensive care experience questionnaire in Korean critical care survivors. Asian Nurs Res. 2020;14(2):89\u0026ndash;96. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.anr.2020.03.002\u003c/span\u003e\u003cspan address=\"10.1016/j.anr.2020.03.002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRattray J, Johnston M, Wildsmith JA. The intensive care experience: development of the ICE questionnaire. J Adv Nurs. 2004;47(1):64\u0026ndash;73. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/j.1365-2648.2004.03066.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1365-2648.2004.03066.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJeong YJ, Kang J. Development and validation of a questionnaire to measure post-intensive care syndrome. Intensive Crit Care Nurs. 2019;55:102756. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.iccn.2019.102756\u003c/span\u003e\u003cspan address=\"10.1016/j.iccn.2019.102756\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRattray J, Crocker C, Jones M, Connaghan J. Patients' perceptions of and emotional outcome after intensive care: results from a multicentre study. Nurs Crit Care. 2010;15(2):86\u0026ndash;93. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/j.1478-5153.2010.00387.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1478-5153.2010.00387.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKang J, Lee M, Cho YS, Jeong JH, Choi SA, Hong J. The relationship between person-centred care and the intensive care unit experience of critically ill patients: A multicentre cross-sectional survey. Aust Crit Care. 2022;35(6):623\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.aucc.2021.10.010\u003c/span\u003e\u003cspan address=\"10.1016/j.aucc.2021.10.010\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJung J, Jang S, Jo S, Lee S. Delirium experience of the intensive care unit patients. J Korean Acad Nurs. 2022;52(2):134\u0026ndash;43. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4040/jkan.21240\u003c/span\u003e\u003cspan address=\"10.4040/jkan.21240\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBohart S, M\u0026oslash;ller AM, Andreasen AS, Waldau T, Lamprecht C, Thomsen T. Effect of patient and family centred care interventions for adult intensive care unit patients and their families: A systematic review and meta-analysis. Intensive Crit Care Nurs. 2022;69:103156. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.iccn.2021.103156\u003c/span\u003e\u003cspan address=\"10.1016/j.iccn.2021.103156\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCabrini L, Landoni G, Antonelli M, Bellomo R, Colombo S, Negro A, et al. Critical care in the near future: patient-centered, beyond space and time boundaries. Minerva anestesiol. 2016;82(5):599\u0026ndash;604.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCort\u0026eacute;s-Beringola A, Vicent L, Mart\u0026iacute;n-Asenjo R, Puerto E, Dom\u0026iacute;nguez-P\u0026eacute;rez L, Maruri R, et al. Diagnosis, prevention, and management of delirium in the intensive cardiac care unit. Am Heart J. 2021;232:164\u0026ndash;76. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ahj.2020.11.011\u003c/span\u003e\u003cspan address=\"10.1016/j.ahj.2020.11.011\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKang J, Cho YS, Lee M, Yun S, Jeong YJ, Won YH, et al. Effects of nonpharmacological interventions on sleep improvement and delirium prevention in critically ill patients: A systematic review and meta-analysis. Aust Crit Care. 2023;36(4):640\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.aucc.2022.04.006\u003c/span\u003e\u003cspan address=\"10.1016/j.aucc.2022.04.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRenckens SC, Pasman HR, Klop HT, du Perron C, van Zuylen L, Steegers MAH, et al. Support for relatives in the intensive care unit: Lessons from a cross-sectional multicentre cohort study during the COVID-19 pandemic. BMC Health Serv Res. 2023;23(1):763. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12913-023-09756-2\u003c/span\u003e\u003cspan address=\"10.1186/s12913-023-09756-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRose L, Yu L, Casey J, Cook A, Metaxa V, Pattison N, et al. Communication and virtual visiting for families of patients in intensive care during the COVID-19 Pandemic: A UK national survey. Ann Am Thorac Soc. 2021;18(10):1685\u0026ndash;92. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1513/AnnalsATS.202012-1500OC\u003c/span\u003e\u003cspan address=\"10.1513/AnnalsATS.202012-1500OC\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrown SM, Bose S, Banner-Goodspeed V, Beesley SJ, Dinglas VD, Hopkins RO. Approaches to addressing post-Intensive care syndrome among intensive care unit survivors. A narrative review. Ann Am Thorac Soc. 2019;16(8):947\u0026ndash;56. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1513/AnnalsATS.201812-913FR\u003c/span\u003e\u003cspan address=\"10.1513/AnnalsATS.201812-913FR\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBoehm LM, Danesh V, Eaton TL, McPeake J, Pena MA, Bonnet KR, et al. Multidisciplinary ICU recovery clinic visits: A qualitative analysis of patient-provider dialogues. Chest. 2023;163(4):843\u0026ndash;54. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.chest.2022.10.001\u003c/span\u003e\u003cspan address=\"10.1016/j.chest.2022.10.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003evan Sleeuwen D, van de Laar FA, Simons K, van Bommel D, Burgers-Bonthuis D, Koeter J, et al. MiCare study, an evaluation of structured, multidisciplinary and personalised post-ICU care on physical and psychological functioning, and quality of life of former ICU patients: a study protocol of a stepped-wedge cluster randomised controlled trial. BMJ open. 2022;12(9):e059634. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1136/bmjopen-2021-059634\u003c/span\u003e\u003cspan address=\"10.1136/bmjopen-2021-059634\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKwon BS. Rehabilitation medicine healthcare supply and delivery system. J Korean Med Assoc. 2017;60(11):860\u0026ndash;3. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5124/jkma.2017.60.11.860\u003c/span\u003e\u003cspan address=\"10.5124/jkma.2017.60.11.860\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGeense WW, Zegers M, Peters MAA, Ewalds E, Simons KS, Vermeulen H, et al. New physical, mental, and cognitive problems 1 year after ICU admission: A prospective multicenter study. Am J Respir Crit Care Med. 2021;203(12):1512\u0026ndash;21. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1164/rccm.202009-3381OC\u003c/span\u003e\u003cspan address=\"10.1164/rccm.202009-3381OC\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarra A, Pandharipande PP, Girard TD, Patel MB, Hughes CG, Jackson JC, et al. Co-occurrence of post-intensive care syndrome problems among 406 survivors of critical illness. Crit Care Med. 2018;46(9):1393\u0026ndash;401. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/CCM.0000000000003218\u003c/span\u003e\u003cspan address=\"10.1097/CCM.0000000000003218\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRamnarain D, Aupers E, den Oudsten B, Oldenbeuving A, de Vries J, Pouwels S. Post intensive care syndrome (PICS): an overview of the definition, etiology, risk factors, and possible counseling and treatment strategies. Expert Rev Neurother. 2021;21(10):1159\u0026ndash;77. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/14737175.2021.1981289\u003c/span\u003e\u003cspan address=\"10.1080/14737175.2021.1981289\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFalvey JR, Cohen AB, O'Leary JR, Leo-Summers L, Murphy TE, Ferrante LE. Association of social isolation with disability burden and 1-year mortality among older adults with critical illness. JAMA Intern Med. 2021;181(11):1433\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1001/jamainternmed.2021.5022\u003c/span\u003e\u003cspan address=\"https://doi:10.1001/jamainternmed.2021.5022\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Critical Care Outcomes, Intensive Care Units, Patient Experience, Person-Centred Care, Post-Intensive Care Syndrome","lastPublishedDoi":"10.21203/rs.3.rs-4263750/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4263750/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Several risk factors for post-intensive care syndrome have been recognised, but the majority of them cannot be altered. While there is potential for negative experiences in the intensive care unit and person-centred care to impact post-intensive care syndrome, the evidence linking the three is insufficient. This study aimed to investigate the impact of person-centred care and the patient’s experience in the intensive care unit on post-intensive care syndrome among critical care survivors during the first year following hospital discharge.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThe study was a prospective, multi-centre longitudinal cohort study.\u003cstrong\u003e \u003c/strong\u003eThis study was conducted in 19 intensive care units at four university hospitals located in Busan, South Korea.\u003cstrong\u003e \u003c/strong\u003eThe participants were 618 adults who had been admitted to the intensive care unit for more than 24 hours between May 2019 and July 2021.\u003cstrong\u003e \u003c/strong\u003eAt the time of intensive care unit discharge, participants completed a person-centred care and an intensive care experience questionnaire. We evaluated the post-intensive care syndrome of the participants 3, 6 and 12 months after hospital discharge.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The frightening experience in the intensive care unit was a factor that significantly increased post-intensive care syndrome at 3 and 6 months. Person-centred care partially mediated the impact of the frightening experience on post-intensive care syndrome, mitigating its effect. Female gender, older age, comorbidities, delirium and discharge to an extended care facility were factors that increased post-intensive care syndrome at 3, 6 and 12 months. Furthermore, comorbidities and discharge place had a statistically significant influence on the participants' post-intensive care syndrome changes over the course of one year.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The findings of this study support the development and implementation of person-centred interventions that reduce patients' frightening experiences in the intensive care unit in order to enhance long-term outcomes. Additionally, the post-intensive care syndrome of survivors who are discharged to an extended care facility requires special attention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRegistration:\u003c/strong\u003e This study is registered at the Korean Clinical Research Information Service (#KCT0004045; date of registration: June 11, 2019; date of 1\u003csup\u003est\u003c/sup\u003e participant recruitment: June 7, 2019).\u003c/p\u003e","manuscriptTitle":"Effects of person-centred care and intensive care experience on post-intensive care syndrome in critical care survivors: a multi-centre prospective cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-29 15:30:09","doi":"10.21203/rs.3.rs-4263750/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3c6d0c82-ff7c-4764-82f5-2efbfea7e0ba","owner":[],"postedDate":"April 29th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-10-21T18:02:29+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-29 15:30:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4263750","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4263750","identity":"rs-4263750","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}