Four in ten family members of sepsis survivors still had mental health problems at a year

Design

Prospective multicentre cohort

Population

94 sepsis survivor–caregiver pairs from 21 ICUs in Japan

Primary outcome

Caregiver mental health problems at 3, 6 and 12 months

Effect

43% at 3 months, 42% at 12; link with patient mental symptoms aOR 3.71 (95% CI 2.03–6.77)

A prospective study in 21 Japanese ICUs followed 94 sepsis survivors and their next of kin, assessing both at three, six and 12 months after discharge. Patients had a median age of 74; caregivers 67, and many were spouses.

Mental health problems in caregivers, such as anxiety, depression and post-traumatic stress symptoms, were present in 43% at three months and 42% at 12 months, showing no recovery over the year, while patients' own post-intensive care symptoms fell from 82% to 62%. Caregiver problems were strongly associated with the patient's mental symptoms (aOR 3.71), not with physical or cognitive impairment.

The sample is small and the association does not show which way influence runs. But it reinforces that the family's illness after critical care can outlast the patient's. Intensive care follow-up that asks only about the patient misses half the problem.

• Ask relatives of ICU sepsis survivors about their own sleep, mood and anxiety at follow-up.
• Screen the patient for anxiety, depression and post-traumatic stress, which tracked most closely with caregiver distress.
• Give families written information about post-intensive care syndrome before discharge.
• Refer caregivers to primary care or psychological support when symptoms persist.

Why it matters

Caregiver distress did not fade over a year, unlike the patient's symptoms.

Don't overread it

A small observational study; it cannot show that treating patients' symptoms would help caregivers.

The statistics, in plain English

An adjusted odds ratio of 3.71 means caregiver mental problems were nearly four times as likely when the patient had mental symptoms. With 94 pairs, the interval is wide (2.03 to 6.77) and the estimate is imprecise.

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