Abstract:

Objective From a gender perspective，to investigate the longitudinal relationships between cognitive，physical，and psychological dysfunction of post-intensive care syndrome（PICS）among ICU survivors within 3 months after being transferred out of the ICU，and clarify the moderating role of gender. Methods 584 critically ill patients transferred from medical and surgical ICUs of a tertiary grade-A hospital in Shandong Province（September 2023-February 2024） was included by convenient sampling. They were grouped by gender，and their cognitive，physical，and psychological dysfunction were assessed at 1 month （T1） and 3 months （T2） post-ICU discharge. A cross-hysteresis model was constructed to explore the longitudinal relationship and gender difference between the three domains of PICS. Results The severity of PICS at the two follow-ups showed a downward trend（Z=-7.431，P <0.01），and this trend was consistent among different gender groups. Autoregressive effects stably maintained longitudinal relationships among the three dysfunctions（β=0.55，0.51，0.39），with positive correlations observed at both time points. Cross-lagged analysis revealed that T1 cognitive impairment significantly predicted T2 physical impairment in both male and female groups. T1 physical impairment significantly predicted T2 cognitive and psychological impairments only in males. Conclusion Longitudinal relationships between cognitive，physical，and psychological impairments vary by sex within 3 months post-ICU discharge. Early and targeted interventions based on gender for ICU patients can effectively prevent the occurrence，maintenance，and deterioration of functional disorders in the later stages.

Key words: Cognitive Impairment, Physical Impairment, Psychological Impairment, Post-Intensive Care Syndrome, Cross-Lagged Panel Analysis, Longitudinal studies