ЖурналыПодпискаАрхивКнигиПроектыО насРекламаДоставка/ОплатаКонтакты
+7 (495) 482-43-29
  • Главная
  • / Журналы
  • / Вернуться в журнал
  • / Содержание номера
  • / Статья
Post intensive care syndrome as a prognostic factor in patients with acute cerebral insufficiency

Post intensive care syndrome as a prognostic factor in patients with acute cerebral insufficiency

Authors:
Вадим Иванович Ершов,
Андрей Августович Белкин,
Алексей Сергеевич Добрынин

Журнал: Анестезиология и реаниматология. 2026;(2):19-25.

DOI: 10.17116/anaesthesiology202602119

Read: 2092 раза

Download PDF (RU)Download PDF (EN)

Abstract

BACKGROUND

Post intensive care syndrome (PICS) is unfavorable prognostic factor in patients with acute cerebral insufficiency (ACI). Prognostic significance of PICS severity in patients with ACI remains unclear.

OBJECTIVE

To determine prognostic value of PICS severity in patients with ACI.

MATERIAL AND METHODS

The study included 115 patients with ACI following ischemic or hemorrhagic stroke in acute period of disease. We assessed neurological disorders using the NIHSS scale, ACI severity according to the FOUR scale and the GCS scale. PICS syndrome was diagnosed according to the PICS index in patients with ICU stay≥ 72 hours. Significance of this index for outcomes in patients with ACI was determined. We analyzed dependence of probable mortality on ACI severity as of day 3 for PICS score ≥3 and <3.

RESULTS

In comparative analysis of PICS modalities in ACI patients on day 3, decrease in gravitational gradient prevailed in 44.3% of patients and decrease in exercise tolerance in 64.3% of patients. Comparison of PICS modalities according to ACI severity revealed significant differences for complications such as decreased gravity gradient, polymyoneuropathy of critical conditions, respiratory polymyoneuropathy, dysphagia. The share of favorable outcomes (GOS grade 3—5) in patients with PICS index <3 was higher (60.7%) compared to patients with PICS index ≥3 (24.1%). According to regression analysis, PICS affects the risk of death in patients with ACI and FOUR score 4—13.

CONCLUSIONS

The PICS index has high sensitivity and specificity for predicting death in patients with acute cerebral insufficiency. Regression analysis showed that unfavorable outcome is significantly more common in severe PICS (p<0.005). At the same time, PICS index ≥3 is associated with worse prognosis compared to PICS index <3 in patients with FOUR score 4—13 on day 3.

Keywords

  • post intensive care syndrome (PICS)
  • acute cerebral insufficiency
  • acute cerebrovascular accident
  • prognosis of outcome

Дата поступления: 09.07.2025

Дата принятия в печать: 02.09.2025

Дата публикации: 23.04.2026

References
  1. Belkin AA, Alasheev AM, Belkin VA, Belkina YB, Belova AN, Belskii DV, Bodrova RA, Bryusov GP, Varako NA, Voznyuk IA, Gorbachev VI, Grechko AV, Gumarova LSh, Daminov VD, Ershov VI, Zhiguzhevskiy RA, Zabolotskikh IB, Zaytsev OS, Zakharov VO, Zinchenko YP, Ivanova GE, Kaurkin SN, Knyazenko PA, Kovyazina MS, Kondratiev AN, Kondratyeva EA, Kostenko EV, Kulakova AA, Krylov VV, Kupreychik VL, Laysheva OA, Lebedinskii KM, Levit AL, Leiderman IN, Lubnin AYu, Lukoianova EA, Maltceva MN, Makarova MR, Melnikova EV, Mitrakov NN, Mishina IE, Pomeshkina SA, Petrikov SS, Petrova MV, Pinchuk EA, Piradov MA, Popugaev KA, Polyakova AV, Pogonchenkova IV, Protsenko DN, Raseva NV, Rudnik YN, Rudnov VA, Ryabinkina YV, Savin IA, Safonova TYu, Semenova GB, Skripai EY, Solodov AA, Suvorov AYu, Suponeva NA, Tokareva DV, Urazov SP, Usachev DYu, Fadeeva AS, Khasanova DR, Khasanshin VT, Tsarenko SV, Chuprina SE, Shestopalov YYu, Shchegolev AV, Shchikota AM, Engaus RE, Norvils SN. Rehabilitation in the intensive care unit (RehabICU). Clinical practice recommendations of the national Union of Physical and Rehabilitation Medicine Specialists of Russia and of the national Federation of Anesthesiologists and Reanimatologists. Russian Federation of anesthesiologists and reanimatologists guidelines. Annals of Critical Care. 2022;(2):7-40. (In Russ.). https://doi.org/10.21320/1818-474X-2022-2-7-40
  2. Belkin AA, Rudnik EN, Belkin VA, Nagaev NS, Pinchuk EA, Rudnik AE, Tkachuk MM.. Development and validation of the PICS-index to assess the severity of the syndrome of consequences of intensive care: a descriptive, prospective, and unmatched cohort study. Annals of Critical Care. 2024; 4:58-72. (In Russ.). https://doi.org/10.21320/1818-474X-2024-4-58-72
  3. Belkin AA. Syndrome Effects of Intensive Therapy — Post Intensive Care Syndrome (PICS). Annals of Critical Care. 2018;2:12-23. (In Russ.). https://doi.org/10.21320/1818-474X-2018-2-12-23
  4. Intensivnaya terapiya: natsional’noe rukovodstvo. V 2 t. Tom 1. Zabolotskikh IB, Protsenko DN. 2-e izd., pererab. i dop. M.: GEOTAR-Media; 2021. (In Russ.).
  5. Kang J, Jeong YJ, Hong J. The effect of postintensive care syndrome on the quality of life of intensive care unit survivors: A secondary analysis. Australian Critical Care. 2021;34(3):246-253. https://doi.org/10.1016/j.aucc.2020.08.006
  6. Stam HJ, Stucki G, Bickenbach J; European Academy of Rehabilitation Medicine. Covid-19 and Post Intensive Care Syndrome: A Call for Action. Journal of Rehabilitation Medicine. 2020;52(4):jrm00044. https://doi.org/10.2340/16501977-2677
  7. Woodruff AG, Choong K. Long-Term Outcomes and the PostIntensive Care Syndrome in Critically Ill Children: A North American Perspective. Children (Basel). 2021;8(4):254. https://doi.org/10.3390/children8040254
  8. Smith JM, Lee AC, Zeleznik H, Coffey Scott JP, Fatima A, Needham DM, Ohtake PJ. Home and community-based physical therapist management of adults with post-intensive care syndrome. Physical Therapy. 2020;100(7): 1062-1073. https://doi.org/10.1093/ptj/pzaa059
  9. Harvey MA. The truth about consequence — Post-intensive care syndrome in intensive care unit survivors and their families. Critical Care Medicine. 2012;40(8):2506-2507. https://doi.org/10.1097/CCM.0b013e318258e943
  10. Belkin AA. The somnological aspects of the patient’s stay in the resuscitation and intensive care unit. Consilium Medicum. 2017;19(2.3. Nevrologiya i revmatologiya):34-37. (In Russ.).
  11. Belkin VA, Vasilchenko IE, Belkin AA. Dynamics of emotional-cognitive and motor disorder domains in the Post Intensive Care Syndrome structure in acute cerebral insufficiency patients. Fizicheskaya i reabilitatsionnaya meditsina, meditsinskaya reabilitatsiya. 2024;6(4):348-359. (In Russ.). https://doi.org/10.36425/rehab635419
  12. Arslanov OZ, Belkin AA. The FOUR scale in intensive care and rehabilitation of patients with acute cerebral injury. The first results of a two-stage study. Russian Journal of Anesthesiology and Reanimatology. 2025;1:21-29. (In Russ.). https://doi.org/10.17116/anaesthesiology202501121
  13. Piradov MA, Suponeva NA, Yatsko KA, Yusupova DG, Zimin AA, Legostaeva LA, Yazeva EG, Domashenko MA, Samorukov VYu, Belkin AA, Kondratieva EA, Kondratiev SA, Ramazanov GR, Kovaleva EA, Popugaev KA, Petrikov SS, Ryabinkina YuV. Full Outline of UnResponsiveness (FOUR) Scale: a Multicenter Validation Study of the Psychometric Properties of the Approved Russian Version. General Reanimatology. 2024;20(3): 15-21. (In Russ.). https://doi.org/10.15360/1813-9779-2024-3-2428
  14. Iwashyna TJ, Hodgson CL, Pilcher D, Bailey M, van Lint A, Chavan S, Bellomo R. Timing of onset and burden of persistent critical illness in Australia and New Zealand: a retrospective, population-based, observational study. Lancet Respiratory Medicine. 2016;4(7):566-573. https://doi.org/10.1016/S2213-2600(16)30098-4
  15. Iwashyna TJ, Hodgson CL, Pilcher D, Bailey M, Bellomo R. Persistent critical illness characterised by Australian and New Zealand ICU clinicians. Critical Care and Resuscitation. 2015;17(3):153-158.
  16. Bagshaw SM, Stelfox HT, Iwashyna TJ, Bellomo R, Zuege D, Wang X. Timing of onset of persistent critical illness: a multi-centre retrospective cohort study. Intensive Care Mediicine. 2018;44(12):2134-2144. https://doi.org/10.1007/s00134-018-5440-1
  17. Viglianti EM, Kramer R, Admon AJ, Sjoding MW, Hodgson CL, Bellomo R, Iwashyna TJ. Late organ failures in patients with prolonged intensive care unit stays. Journal of Critical Care. 2018;46:55-57. https://doi.org/10.1016/j.jcrc.2018.03.029
  18. Darvall JN, Boonstra T, Norman J, Murphy D, Bailey M, Iwashyna TJ, Bagshaw SM, Bellomo R. Persistent critical illness: baseline characteristics, intensive care course, and cause of death. Critical Care and Resuscitation. 2019; 21(2):110-118.
  19. Karpova OV, Kruglyakov NM, Zhalnina ND, Eroshkin KE. The course of post intensive care syndrome in patients with severe cerebral insufficiency and predictors of recovery. Clinical observation. Fizicheskaya i reabilitatsionnaya meditsina, meditsinskaya reabilitatsiya. 2023;5(1):80-92. (In Russ.). https://doi.org/10.36425/rehab139207
  20. Ershov VI, Silkin VV, Chirkov AN, Golubkina AA. Prognostic value of dynamic characteristics of multiple organ failure in severe ischemic stroke. Russian Journal of Anesthesiology and Reanimatology. 2023;2:27-33. (In Russ.). https://doi.org/10.17116/anaesthesiology202302127
  21. Silkin VV, Ershov VI, Burdakov VV, Biryukova TV, Bredikhin AYu, Lozinskaya TYu. Mathematical modeling of severe ischemic stroke with multiple organ failure: a retrospective observational study. Annals of Critical Care. 2023;1:91-100. (In Russ.). https://doi.org/10.21320/1818-474X-2023-1-91-100
slide-cover

Recommended articles:

The influence of polymorphic variants of folate metabolism genes on homocysteine levels in patients with acute cerebrovascular accident.Laboratory Service. 2026;15(2):15-19

The FOUR scale in assessing patients with acute cerebral insufficiency.Burdenko's Journal of Neurosurgery. 2026;90(1):57-64

The effect of Mexidol on the level of neurogenesis markers in acute cerebrovascular accident in the experiment.S.S. Korsakov Journal of Neurology and Psychiatry. 2025;125(2):107-112

The FOUR scale in intensive care and rehabilitation of patients with acute cerebral injury. The first results of a two-stage study.Russian Journal of Anesthesiology and Reanimatology. 2025;(1):21-29

Evaluation of the effectiveness of the drug Cortexin in combination with the use of the application Aphasia.No (Afaziyam.Net) in the correction of speech disorders in patients with cerebral infarction.S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(11):147-151

Издательство «Медиа Сфера»
РекламаДоставка/ОплатаО насКонтактыОбучение для редакцийПолитика конфиденциальностиПолитика обработки персональных данныхПубличная оферта на реализацию издательской продукции
ЖурналыПодпискаАрхивКнигиПроекты
  • RuStore

© 1998-2026

  • Телефоны издательства:

  • +7 (495) 482-41-18
  • +7 (495) 482-43-29

  • Прямой телефон отдела подписки
    (только по вопросам заказов и доставки журналов)

  • +7 (800) 250-18-12

  • пн-пт с 10:00 до 18:00

  • Telegram
  • VK
info@mediasphera.ru

  • Почтовый адрес:

  • Издательство «Медиа Сфера»,
    а/я 54, Москва, Россия, 127238

  • RuStore

© 1998-2026