Admission predictors of post-intensive care syndrome family among caregivers of ICU survivors: A secondary analysis

OBJECTIVES: To identify ICU admission predictors of psychological, physical, and cognitive post-intensive care syndrome family (PICS-F) impairments.

METHODS: A secondary analysis of a prospective cohort study. The sample included 139 caregivers of ICU survivors with 3-10 days of ICU stay and respiratory support at enrollment. Caregivers completed sociodemographic questionnaires and validated instruments assessing anxiety/depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, vitality, cognitive function, perceived social support, resilience, and family satisfaction at ICU admission and 3 months post-discharge. Prevalence was estimated with percentages, and candidate predictors were identified from the literature and bivariate analyses, then refined using LASSO regressions. Selected predictors were analyzed using logistic regression models for each PICS-F impairment.

RESULTS: At 3-month follow-up, PICS-F prevalence was 22.3% for anxiety/depressive symptoms, 26.6% for PTSD symptoms, 38.1% for fatigue, and 2.9% for mild cognitive dysfunction. Significant predictors for anxiety/depressive symptoms were spouse/partner status (OR = 0.17; 95%CI: 0.03-0.64), elementary education (OR = 7.54; 95%CI:2.05-31.08), and admission anxiety/depressive symptoms (OR = 1.19; 95%CI:1.00-1.43). For PTSD symptoms, male gender (OR = 0.26; 95%CI:0.05-0.88) and admission anxiety/depressive symptoms (OR = 1.31; 95%CI:1.12-1.57) were significant. Perceived social support was the sole significant predictor of fatigue (OR = 0.98; 95%CI:0.97-1.00). No significant predictors were identified for mild cognitive impairment risk.

CONCLUSIONS: Caregivers of ICU survivors face substantial risk for psychological and physical PICS-F impairments. Caregivers with lower educational attainment, elevated psychological distress at ICU admission, and limited perceived social support appear particularly vulnerable. Early identification of high-risk caregivers during ICU admission can inform targeted interventions to mitigate long-term psychological and physical consequences.

IMPLICATIONS FOR CLINICAL PRACTICE: Psychosocial screening of caregivers within the first days of ICU admission is essential to guide timely, tailored PICS-F interventions. ICU staff should be aware of the multidimensional nature of PICS-F and understand associated risk and protective factors.