ICU sedation, delirium & recovery
Risk factors, biomarkers, and mechanisms for persistent inflammation, immunosuppression, and catabolism syndrome (PICS): a systematic review and meta-analysis
Authors' conclusion
While older patients and those with co-morbidities could be at greater risk for PICS, acquired risk factors, such as injury severity, are potentially more predictive of PICS than intrinsic patient characteristics.
Study context
- Population
- Adult ICU survivors6 studies
- Comparison
- PICS vs no PICS, chronic critical illness (CCI), or rapid recovery
- Outcome
- Risk factors, biomarkers, and biological mechanisms underlying PICS
Methodological detailsrandom effects DerSimonian-Laird, Newcastle-Ottawa Scale risk of bias, 5 single-centre retrospective cohort studies, 1 prospective cohort study; sample sizes 22 to 391
- Random effects DerSimonian-Laird
- Newcastle-Ottawa Scale risk of bias
- 5 single-centre retrospective cohort studies, 1 prospective cohort study; sample sizes 22 to 391
Pooled result
As reported in the abstract
Biomarkers (meta-analysis)
Each group vs non-PICSMD (C-reactive protein, higher), mg L-1 (95% CI)P value
PICS
34.4(12.7–56.2)
P < 0.01- PICS
- MD (albumin, lower) 4.4 g L-1 (95% CI 0.5–8.3); P < 0.01
- PICS
- MD (lymphocyte count, lower) 0.36 ×109 L-1 (95% CI 0.25–0.47); P = 0.01
- Increased incidence of PICS with age
- 2 studies
- Association between PICS and Charlson Comorbidity Index scores
- 2 studies
- PICS associated with requiring mechanical ventilation
- 4 studies
Original publication
Risk factors, biomarkers, and mechanisms for persistent inflammation, immunosuppression, and catabolism syndrome (PICS): a systematic review and meta-analysis. Br J Anaesth. Published 30 April 2024. doi:10.
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