Long-Lasting Mental Disorders in Caregivers of ICU Sepsis Survivors and Their Association With Patients’ Post-Intensive Care Syndrome: A Prospective Multicenter Cohort Study

OBJECTIVES: 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. DESIGN: Prospective observational study. SETTING: Twenty-one mixed ICUs. PATIENTS: Caregivers (the next of kin) of the patients diagnosed with sepsis between November 2020 and April 2022. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: 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. CONCLUSIONS: 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.

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Journal
Critical Care Medicine
Published
2026-10-14
DOI
https://doi.org/10.1097/ccm.0000000000007378
Primary Topic
Intensive Care Unit Cognitive Disorders
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article

Long-Lasting Mental Disorders in Caregivers of ICU Sepsis Survivors and Their Association With Patients’ Post-Intensive Care Syndrome: A Prospective Multicenter Cohort Study

Hajime Katsukawa, David J. McWilliams, Hidehiko Nakano, Masaki Okajima et al.
Critical Care Medicine
Intensive Care Unit Cognitive Disorders
article

Long-Lasting Mental Disorders in Caregivers of ICU Sepsis Survivors and Their Association With Patients’ Post-Intensive Care Syndrome: A Prospective Multicenter Cohort Study

Hajime Katsukawa, David J. McWilliams, Hidehiko Nakano, Masaki Okajima, Kenzo Ishii, Norio Otani, Yasunari Morita, Kasumi Shirasaki, Shutaro Isokawa, Peter Nydahl, Keibun Liu, Ayaka Matsuoka, Yutaka Sakuda, Manabu Hanazawa, Toru Kotani, Akira Kawauchi, Nobutake Shimojo, Takashi Hongo, Yuhei Irie, Takayuki Ogura, Kazuki Akieda, Maiko Motoki, Kenji Oike, Tomohiro Hamagami, Kensuke Nakamura, Hiroshi Kamijo, Daisuke Kasugai, S. Schaller, Daigo Shimakura, on behalf of the Investigating Long-term Outcomes of ICU patients with Sepsis or Septic shock (ILOSS) Study Group, Yukiko Tanaka, Masakazu Nitta
article en

Abstract

OBJECTIVES: 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. DESIGN: Prospective observational study. SETTING: Twenty-one mixed ICUs. PATIENTS: Caregivers (the next of kin) of the patients diagnosed with sepsis between November 2020 and April 2022. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: 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. CONCLUSIONS: 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.

Critical Care Medicine
Kanazawa University (JP), SHOWA Medical University (JP), Shinshu University (JP), University of Tsukuba (JP), Okayama University (JP), Shiga University (JP), Saga University (JP), Paracelsus Medical University (AT), University Hospital Coventry (GB), University Hospitals Coventry and Warwickshire NHS Trust (GB), Humboldt-Universität zu Berlin (DE), St. Luke's International Hospital (JP), Tsuchiura Kyodo General Hospital (JP), Fukuoka University Hospital (JP), Tochigi Prefectural Police (JP), University Hospital Schleswig-Holstein (DE), Fukuyama City Hospital (JP), Okinawa Prefectural Chubu Hospital (JP), Saiseikai Utsunomiya hospital (JP), Niigata University Medical and Dental Hospital (JP), Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital (JP), Japanese Red Cross Narita Hospital (JP), Tsukuba Medical Center Hospital (JP), Toyooka Hospital (JP), Aso Iizuka Hospital (JP), Okayama Saiseikai General Hospital (JP), Hitachi General Hospital (JP), United States Naval Hospital Okinawa (JP), Nagoya Medical Center (JP), Nagoya University (JP), Kobe University (JP), Coventry University (GB), Medical University of Vienna (AT), Charité - Universitätsmedizin Berlin (DE)
Good health and well-being
Openalex Percentile: Top 11%
Intensive Care Unit Cognitive Disorders
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