• Am. J. Crit. Care · Jan 2024

    Multicenter Study

    Association of Lack of Fear of Dying With New Organ Failure: Results of a Multicenter Prospective Cohort Study.

    • Aurélien Mazeraud, Guillaume Turc, Sivanthiny Sivanandamoorthy, Raphaël Porcher, Annabelle Stoclin, Marion Antona, Andrea Polito, Cassia Righy, Fernando A B Bozza, Shidasp Siami, and Tarek Sharshar.
    • Aurélien Mazeraud is an intensivist/anesthesiologist, GHU Paris Psychiatrie et Neurosciences Pole Neuro-Anesthesiology and Intensive Care and Université de Paris, Paris, France.
    • Am. J. Crit. Care. 2024 Jan 1; 33 (1): 364436-44.

    BackgroundPatients' anxiety on intensive care unit (ICU) admission is associated with subsequent deterioration.ObjectiveTo assess whether patients' fears/anxiety are predictive of new organ failure within 7 days of ICU admission.MethodsIn a prospective 3-center cohort study of non-comatose patients without delirium or invasive mechanical ventilation, 9 specific fears were evaluated through yes/no questions. Illness severity was assessed using the Simplified Acute Physiology Score II (SAPS II) and the Sequential Organ Failure Assessment (SOFA). Intensity of acute and chronic anxiety was assessed with the state and trait components of the State-Trait Anxiety Inventory (STAI). Patients were followed up for 7 days.ResultsFrom April 2014 to December 2017, 373 patients (median [IQR] age, 63 [48-74] years; 152 [40.8%] women; median (IQR) SAPS II, 27 [19-37]) were included. Feelings of vulnerability and fear of dying were reported by 203 (54.4%) and 172 (46.1%) patients, respectively. The STAI-State score was 40 or greater in 192 patients (51.5%). Ninety-four patients (25.2%) had new organ failure. Feelings of vulnerability (odds ratio, 1.96 [95% CI, 1.12-3.43]; P=.02) and absence of fear of dying (odds ratio, 2.38 [95% CI, 1.37-4.17]; P=.002) were associated with new organ failure after adjustment for STAI-State score (≥40), SAPS II, and SOFA score.ConclusionAbsence of fear of dying is associated with new organ failure within the first 7 days after ICU admission. Fear of dying may protect against subsequent deterioration by mobilizing patients' homeostatic resources. ClinicalTrials.gov Identifier: NCT02355626.©2024 American Association of Critical-Care Nurses.

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