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Volume 17 Supplement 4

Sepsis 2013

  • Poster presentation
  • Open Access

Does the ICU experience predict psychological symptoms in relatives of patients with severe sepsis and end-of-life decisions?

  • 1, 2,
  • 2,
  • 1,
  • 1,
  • 3,
  • 4 and
  • 1, 2
Critical Care201317 (Suppl 4) :P60

  • Published:


  • Medical Care
  • Multiple Linear Regression
  • Severe Sepsis
  • Linear Regression Model
  • Event Scale


Severe sepsis is the main cause of death in the ICU. Relatives are at risk for post-traumatic stress disorder (PTSD) or anxiety and depression [1]. The objective is to assess whether the ICU experience may predict these psychological symptoms of relatives at 90 days after the patient's death or discharge.

Materials and methods

Prospective observational study in four ICUs of one university hospital, including all patients with severe sepsis and end-of-life-decisions. At 90 days, the main relative was interviewed with the Impact of Event Scale (to measure PTSD), the Hospital Anxiety and Depression Scale and self-developed items on satisfaction with the ICU experience, including medical care and communication in general as well as specifically in the end-of-life context, and decision-making. Three multiple linear regression models were calculated to predict anxiety, depression and post-traumatic stress each.


Eighty-four relatives were included. They were mostly female (74%), spouse (42%) or child (42%), median age was 57 years. Seventy-seven percent acted as proxies. After 90 days, 51% relatives were at risk for PTSD, 48% for anxiety and 33% for depression. Overall satisfaction with the ICU experience was high. Relatives' satisfaction with medical care and communication in general predicted lower anxiety (P = 0.025).


Relatives of patients with sepsis have a high psychological burden. Improving communication between ICU staff and relatives may reduce their symptoms of anxiety.



Funded partly by the German Ministry of Education and Research (grant number 01 E0 1002). This investigation was part of a study to improve quality of end-of-life care in the ICU (trial registration NCT01247792).

Authors’ Affiliations

Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
Center for Sepsis Control & Care, Jena University Hospital, Jena, Germany
Department of Internal Medicine I, Jena University Hospital, Jena, Germany
Department of Neurology, Jena University Hospital, Jena, Germany


  1. Azoulay E, Pochard F, Kentish-Barnes N, Chevret S, Aboab J, Adrie C, Annane D, Bleichner G, Bollaert PE, Darmon M, Fassier T, Galliot R, Garrouste-Orgeas M, Goulenok C, Goldgran-Toledano D, Hayon J, Jourdain M, Kaidomar M, Laplace C, Larche J, Liotier J, Papazian L, Poisson C, Reignier J, Saidi F, Schlemmer B: Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med 2005, 171: 987-994. 10.1164/rccm.200409-1295OCView ArticlePubMedGoogle Scholar


© Hartog et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.