Journal Article Annotations
2020, 3rd Quarter
Annotations by O.Joseph Bienvenu, MD, PhD
PUBLICATION #1 — Critical Care
In a previous pilot study involving patients with Guillain-Barré syndrome, the authors noted that anxiety was the earliest predictor of respiratory deterioration. In the current study, the authors found that high state anxiety predicted subsequent new organ failure, even when adjusting for illness severity and respiratory status. Notably, as one might guess, high anxiety was particularly strongly associated with subsequent respiratory failure. It was also associated with longer length of stay in the ICU and hospital.
Strength and weaknesses:
This was a large, multi-site study, and the authors did a nice job accounting for potential confounding variables. However, it was an observational study, and the physiologic mechanisms relating anxiety and subsequent clinical deterioration are unclear.
This study illustrates the prognostic importance of anxiety early in the course of critical illness. I think of anxiety in this case as a marker of risk for clinical deterioration (as delirium can be), though as the authors note, the mechanisms relating anxiety and subsequent organ failure are unclear.
Type of study(EBM guide):