40 CHAPTER 3 ABSTRACT Background: Intensive care unit (ICU)-survivors often suffer from long-term mental problems and a reduced health-related quality of life (HRQoL). Symptoms of depression, anxiety, and post-traumatic stress disorder may render patients mentally frail post-ICU, resulting in impaired recovery and an increased informal caregiver burden. The aim of this study was to investigate the prevalence of mental frailty up to 12-months after ICU-admission and pinpoint markers for early risk-assessment in clinical practice. Methods: A retrospective cohort study (2012–2018) in which clinical and post- ICU data of long-stay (≥48h) ICU-patients was used. Mental frailty was identified as clinically relevant symptoms of depression, anxiety, or post-traumatic distress disorder at 12-months after discharge. Results: The prevalence of mental frailty at 12-months post-ICU among the total group of 239 patients was 38%. Mental frailty was defined as clinically relevant symptoms of depression, anxiety, and/or trauma. To achieve this, previously validated cut off values were used for the HADS (HADS-Anxiety≥8; HADS-Depression≥8) and TSQ (≥6), and CSI (≥7). Conclusions: A significant proportion of ICU-survivors can be identified as mentally frail, which is associated with impaired HRQoL at baseline and post-ICU, and high caregiver strain. These findings emphasise the need for integrative aftercare programs for both the patient and their informal caregivers.
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