Association Between Patients' Admission to the ICU and Psychological Disorders in Their Families: A Retrospective Matched-Pair Cohort Study.

Abstract

Objective: This study aimed to evaluate the impact of a family member's ICU admission on post-intensive care syndrome family (PICS-F).

Design: Retrospective, cohort study using a matched-pair, cohort design and a large administrative database reflecting the entire Japanese population.

Setting: The data were provided by DeSC Healthcare (Tokyo, Japan); the database comprised administrative claims data of 3.44 million insurance subscribers.

Patients: The exposure group was defined as family members of ICU patients from April 1, 2014 to November 30, 2022. Then, families of ICU patients were randomly matched to individuals in the non-exposure group with an exposure to non-exposure ratio of 1:4; matching was performed by age (the same month and year of birth), sex, status of medical insurance, and relationship with the householder.

Interventions: None.

Measurements and main results: The primary outcome was the prevalence of psychological disorders associated with a diagnosis of PICS-F that needed medical care at least once within 6 months after the ICU admission date of the matched pair. Multivariable logistic regression analyses and subgroup analyses by relationship to the ICU patient (spouse, parent, or child) were performed.Of the eligible individuals, 35,652 family members of 27,748 ICU patients were matched with 142,463 individuals in the non-exposure group. The prevalence of psychological disorders associated with PICS-F within 6 months from the index date was significantly higher in the ICU patients' families than in the matched individuals (15.1% vs. 13.6%; adjusted odds ratio, 1.08; 95% CI, 1.02-1.15). Similar to the main analyses, ICU patients' spouses had a significantly higher prevalence of psychological disorders associated with PICS-F than matched individuals, but there were no significant differences in ICU patients' parents and children.

Conclusions: Families of ICU patients, especially spouses, were more likely to seek medical care for psychological disorders associated with PICS-F within 6 months than individuals not exposed to a family member's ICU admission.