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Multicenter Study
. 2005 May 1;171(9):987-94.
doi: 10.1164/rccm.200409-1295OC. Epub 2005 Jan 21.

Risk of post-traumatic stress symptoms in family members of intensive care unit patients

Elie Azoulay  1 , Frédéric Pochard, Nancy Kentish-Barnes, Sylvie Chevret, Jérôme Aboab, Christophe Adrie, Djilali Annane, Gérard Bleichner, Pierre Edouard Bollaert, Michael Darmon, Thomas Fassier, Richard Galliot, Maité Garrouste-Orgeas, Cyril Goulenok, Dany Goldgran-Toledano, Jan Hayon, Mercé Jourdain, Michel Kaidomar, Christian Laplace, Jérôme Larché, Jérôme Liotier, Laurent Papazian, Catherine Poisson, Jean Reignier, Fayçal Saidi, Benoît Schlemmer; FAMIREA Study Group
Affiliations
Multicenter Study

Risk of post-traumatic stress symptoms in family members of intensive care unit patients

Elie Azoulay et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Intensive care unit (ICU) admission of a relative is a stressful event that may cause symptoms of post-traumatic stress disorder (PTSD).

Objectives: Factors associated with these symptoms need to be identified.

Methods: For patients admitted to 21 ICUs between March and November 2003, we studied the family member with the main potential decision-making role.

Measurements: Ninety days after ICU discharge or death, family members completed the Impact of Event Scale (which evaluates the severity of post-traumatic stress reactions), Hospital Anxiety and Depression Scale, and 36-item Short-Form General Health Survey during a telephone interview. Linear regression was used to identify factors associated with the risk of post-traumatic stress symptoms.

Main results: Interviews were obtained for family members of 284 (62%) of the 459 eligible patients. Post-traumatic stress symptoms consistent with a moderate to major risk of PTSD were found in 94 (33.1%) family members. Higher rates were noted among family members who felt information was incomplete in the ICU (48.4%), who shared in decision making (47.8%), whose relative died in the ICU (50%), whose relative died after end-of-life decisions (60%), and who shared in end-of-life decisions (81.8%). Severe post-traumatic stress reaction was associated with increased rates of anxiety and depression and decreased quality of life.

Conclusion: Post-traumatic stress reaction consistent with a high risk of PTSD is common in family members of ICU patients and is the rule among those who share in end-of-life decisions. Research is needed to investigate PTSD rates and to devise preventive and early-detection strategies.

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