Influence
April 1, 2025

Post-Intensive Care Syndrome and Caregiver Burden: A Post Hoc Analysis of a Randomized Clinical Trial

Dr. Babar Khan on All IN

Published in JAMA Network Open. Here is a link to the article.

Regenstrief Institute authors: Babar Khan, M.D., M.S.

A recent secondary analysis of the MIND-USA randomized clinical trial evaluated the relationship between post–intensive care syndrome (PICS) in ICU survivors and the burden experienced by their caregivers. The study included 148 adult patient-caregiver pairs from 16 academic medical centers across the United States. Participants were followed at 3 and 12 months post-randomization.

Patients were assessed for physical function, cognitive ability, and PTSD symptoms using standardized tools. Caregivers completed a validated burden questionnaire at the same time points. The analysis revealed that both PICS and caregiver burden at 3 months were significantly associated with their respective outcomes at 12 months. However, no statistically significant longitudinal relationship was found between early PICS and later caregiver burden, or vice versa.

At the 3-month mark, 43.9% of patients showed physical impairments, while 27.7% of caregivers reported high burden levels. By 12 months, patient impairments and caregiver burden remained relatively stable, with a modest decrease in reported caregiver burden. While cross-sectional correlations were confirmed, particularly between physical limitations in patients and caregiver strain, these did not translate into predictive relationships over time.

The findings underscore the importance of evaluating both ICU survivors and caregivers concurrently. Although the study did not demonstrate a reciprocal influence over the long term, the concurrent burden highlights a need for early intervention and ongoing support for both groups following ICU discharge.

The results provide insight into patterns of recovery and caregiver strain, informing future care planning and resource allocation.

Authors:

Soojung Ahn1, Marianna LaNoue2, Han Su2,3, Amanda C Moale4, Leslie P Scheunemann5, Amy L Kiehl3,6, Ivor S Douglas7, Matthew C Exline8, Michelle N Gong9, Babar A Khan10, Robert L Owens11, Margaret A Pisani12, Peter Rock13, James C Jackson3,6,14, E Wesley Ely3,6,15, Timothy D Girard3,16, Leanne M Boehm2,3

Affiliations

1Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.

2School of Nursing, Vanderbilt University, Nashville, Tennessee.

3Critical Illness, Brain dysfunction, and Survivorship Center at Vanderbilt, Nashville, Tennessee.

4Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.

5Department of Medicine, Divisions of Geriatrics and Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.

6Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

7Denver Health Department of Medicine, Pulmonary Sciences and Critical Care Medicine, University of Colorado, Anschutz MC, Denver.

8Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Ohio State University, Columbus.

9Division of Critical Care Medicine, Division of Pulmonary Medicine, Department of Medicine, Montefiore Healthcare System/Albert Einstein College of Medicine, Bronx, New York.

10Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis.

11Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, La Jolla.

12Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.

13Department of Anesthesiology, University of Maryland School of Medicine, Baltimore.

14Geriatric Research Education and Clinical Center, Tennessee Valley Veterans Affairs, Nashville.

15Veterans Affairs Tennessee Valley Health System Geriatric Research, Education, and Clinical Center (GRECC), Nashville.

16Center for Research, Investigation, and Systems Modeling of Acute Illness in the Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

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