43 MENTAL FRAILTY IN ICU-SURVIVORS & INFORMAL CAREGIVER STRAIN 3 (CAM-ICU) and day-to-day status reports.15 As part of standard care protocol, several post-ICU outcomes were collected by outpatient clinic professionals at 3 and 12-months after admission. 3.2.3 Outcome measures HRQoL and mental frailty In patients, HRQoL was assessed using the Dutch version of the 36-Item Short Form Health Survey (Research and Development-36; RAND-36) (0–100, higher is better).16 Mental wellbeing was further assessed using the Hospital Anxiety and Depression Scale (HADS) (0–21 per subscale, higher is worse) and the Trauma Screening Questionnaire (TSQ) (0–10, higher is worse).17,18 Coping strategies were assessed using the Coping Inventory for Stressful Situations (CISS-21) (7–35, higher on subscale is more frequent use of task-oriented, emotional, or avoidance coping style).19 The survey set for caregivers consisted of the Caregiver Strain Index (CSI) (0–13, higher is worse) and a modified caregiver TSQ (0–10, higher is worse).20 Patients were retrospectively allocated to the groupwithmental frailty or the groupwith nomental frailty at 12-months. 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). 3.2.4 Statistical analysis Patient and caregiver data were stored in a coded data file in a dedicated research directory. Demographics, comorbidities, disease aetiology, ICU- morbidity, and post-ICU outcomes are presented for cases with mental frailty and patients without. All data were visually inspected for normality and underwent normality testing using a Shapiro-Wilk approach. As the majority of data were found to be non-normally distributed, results are displayed as median and [interquartile range, IQR] or percentages in case of categorical data. Within-group analyses were conducted using Wilcoxon signed rank tests for continuous data and Related-Samples McNemar Change tests for dichotomous data. Between-group assessment was performed using Mann-Whitney U tests for continuous data or a Chi-square test when comparing group proportions. Odds ratios (OR) for mental frailty at 12-months post-ICU were calculated using binary logistic regression analysis after assessing for collinearity. With this analysis, the impact of clinically relevant characteristics at baseline (delirium in ICU and psychiatric history) and 3-months mental wellbeing scores (trauma, anxiety, depression, and coping scores) on the odds for mental frailty was assessed. For trauma, anxiety, and depression scores, binary variables were
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