Factors Associated With Early Recognition of Persistent Inflammation, Immunosuppression, and Catabolism Syndrome in Critically-Ill Patients Publisher Pubmed



Shahrami B ; Karimpour Razkenari E ; Riazi A ; Sefidani Forough A ; Najmeddin F ; Davari M ; Mojtahedzadeh A ; Mojtahedzadeh M ; Najafi A
Source: Critical Care Nursing Quarterly Published:2026

Abstract

Background: Recent advances in critical care have led to a reduction in early mortality, and an increase in the incidence of persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Factors associated with PICS early recognition were not elucidated. Due to unclarified factors concomitant with PICS, this study was conducted. Methods: Retrospectively, ICU patients were surveyed for chronic critical illness (CCI) and PICS within one year. Patients were divided into PICS (clinical-PICS and marker-positive PICS) and non-PICS groups. Clinical characteristics and factors were compared and analyzed between groups. Results: 100 patients were defined as having a CCI (44 clinical-PICS, 23 marker-positive PICS, 47 non-PICS). Clinical-PICS is associated with higher mortality, ICU duration, and sepsis incidence (P <.05), as well as higher lactate level (OR [CI 95%]; 0.90 [0.82-0.98], P = .01), lower platelet and lymphocyte count (OR [CI 95%]; 1.02 [1.00-1.03], 22.38 [0.72-691.79], P <.05, respectively) on ICU day 14. Acute kidney injuries requiring renal replacement therapy and higher sequential organ failure assessment (SOFA) scores were observed (P <.05). Conclusion: Complicated ICU courses occur in PICS patients, therefore, finding early detection methods and markers is vital. Lactate levels, platelet counts, lymphocyte counts, and SOFA scores on the 14th day, sepsis, transfusion, and RRT during ICU stay are factors that may be predictive of the development of PICS. However further studies are needed for revision of PICS criteria and risk factors. © 2026 Wolters Kluwer Health, Inc. All rights reserved.