by Anne-Françoise
Rousseau, Laurence Dams, Quentin Massart, Laila Choquer, Héléna Cassol, Steven
Laureys, Benoit Misset, Nadia Dardenne, Olivia Gosseries and Charlotte Martial
Critical Care volume 27,
Article number: 76 (2023)
Background
So far, the few prospective studies on near-death experience
(NDE) were carried out only in intensive care unit (ICU) patients with
homogeneous aetiologies, such as cardiac arrest or trauma survivors. The aims
of this 1-year prospective and monocentric study were to investigate the
incidence of NDE in ICU survivors (all aetiologies) as well as factors that may
affect its frequency, and to assess quality of life up to 1 year after
enrolment.
Methods
We enrolled adults with a prolonged ICU stay
(> 7 days). During the first 7 days after discharge, all eligible
patients were assessed in a face-to-face interview for NDE using the Greyson
NDE scale, dissociative experiences using the Dissociative Experience Scale,
and spirituality beliefs using the WHOQOL-SRPB. Medical parameters were
prospectively collected. At 1-year after inclusion, patients were contacted by
phone to measure quality of life using the EuroQol five-dimensional
questionnaire.
Results
Out of the 126 included patients, 19 patients (15%) reported
having experienced a NDE as identified by the Greyson NDE scale (i.e. cut-off
score ≥ 7/32). In univariate analyses, mechanical ventilation, sedation,
analgesia, reason for admission, primary organ dysfunction, dissociative and
spiritual propensities were associated with the emergence of NDE. In
multivariate logistic regression analysis, only the dissociative and spiritual
propensity strongly predicted the emergence of NDE. One year later (n = 61),
the NDE was not significantly associated with quality of life.
Conclusions
The recall of NDE is not so rare in the ICU. In our cohort,
cognitive and spiritual factors outweighed medical parameters as predictors of
the emergence of NDE.
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