Long-Lasting Mental Disorders in Caregivers of ICU Sepsis Survivors and Their Association With Patients' Post-Intensive Care Syndrome: A Prospective Multicenter Cohort Study.
To investigate the prevalence of long-term mental disorders in caregivers of ICU sepsis survivors and examine associations with post-intensive care syndrome (PICS) in patients.
Prospective observational study.
Twenty-one mixed ICUs.
Caregivers (the next of kin) of the patients diagnosed with sepsis between November 2020 and April 2022.
None.
Caregivers and patients were assessed at 3, 6, and 12 months after hospital discharge by telephone and mail. The primary outcome was caregiver mental disorders (mental post-intensive care syndrome-family [PICS-F]). Mixed-effects logistic regression analyses were performed to evaluate the association between caregiver PICS-F and patient PICS. Ninety-four caregiver-patient dyads were analyzed. Caregivers were a median of 67 years old (55-79 yr old), 31 (33.0%) were male, and 41 (43.6%) were spouses. Patients were a median of 74 years old (69-82 yr old), and 54 (57.4%) were male. The prevalence of mental PICS-F did not decrease from 3 to 12 months (43% vs. 42%, respectively), whereas the presence of PICS symptoms in patients decreased from 82% to 62%. In mixed-effects logistic regression, the presence of PICS symptoms in patients was significantly associated with PICS-F (adjusted odds ratio, 3.00; 95% CI, 1.54-5.88; p < 0.01). Among the individual patient PICS domains, only mental PICS was significantly associated with PICS-F (3.71; 2.03-6.77; p < 0.01), whereas physical and cognitive impairments in patients were not.
The prevalence of mental PICS-F in caregivers of ICU sepsis survivors was frequent and long-lasting over the first year after hospital discharge. Since it was most strongly associated with patients' mental disorders rather than physical or cognitive impairments, the mental PICS domain in patients may be an important indicator of PICS-F and should be considered in future studies.
Prospective observational study.
Twenty-one mixed ICUs.
Caregivers (the next of kin) of the patients diagnosed with sepsis between November 2020 and April 2022.
None.
Caregivers and patients were assessed at 3, 6, and 12 months after hospital discharge by telephone and mail. The primary outcome was caregiver mental disorders (mental post-intensive care syndrome-family [PICS-F]). Mixed-effects logistic regression analyses were performed to evaluate the association between caregiver PICS-F and patient PICS. Ninety-four caregiver-patient dyads were analyzed. Caregivers were a median of 67 years old (55-79 yr old), 31 (33.0%) were male, and 41 (43.6%) were spouses. Patients were a median of 74 years old (69-82 yr old), and 54 (57.4%) were male. The prevalence of mental PICS-F did not decrease from 3 to 12 months (43% vs. 42%, respectively), whereas the presence of PICS symptoms in patients decreased from 82% to 62%. In mixed-effects logistic regression, the presence of PICS symptoms in patients was significantly associated with PICS-F (adjusted odds ratio, 3.00; 95% CI, 1.54-5.88; p < 0.01). Among the individual patient PICS domains, only mental PICS was significantly associated with PICS-F (3.71; 2.03-6.77; p < 0.01), whereas physical and cognitive impairments in patients were not.
The prevalence of mental PICS-F in caregivers of ICU sepsis survivors was frequent and long-lasting over the first year after hospital discharge. Since it was most strongly associated with patients' mental disorders rather than physical or cognitive impairments, the mental PICS domain in patients may be an important indicator of PICS-F and should be considered in future studies.
Authors
Shirasaki Shirasaki, Liu Liu, Kawauchi Kawauchi, Isokawa Isokawa, Nakamura Nakamura, Nakano Nakano, Motoki Motoki, Kamijo Kamijo, Matsuoka Matsuoka, Ishii Ishii, Morita Morita, Hongo Hongo, Shimojo Shimojo, Tanaka Tanaka, Hanazawa Hanazawa, Hamagami Hamagami, Oike Oike, Kasugai Kasugai, Sakuda Sakuda, Irie Irie, Nitta Nitta, Akieda Akieda, Shimakura Shimakura, Katsukawa Katsukawa, Kotani Kotani, McWilliams McWilliams, Nydahl Nydahl, Schaller Schaller, Okajima Okajima, Otani Otani, Ogura Ogura,
View on Pubmed