47 MENTAL FRAILTY IN ICU-SURVIVORS & INFORMAL CAREGIVER STRAIN 3 Patients withmental frailtymore often reported the use of avoidance (at 12-months) and emotional coping strategies (at 3 and 12-months) (Table 2). The use of emotional coping strategies increased over time in the mental frailty group. Using multivariate analysis, depression score of ≥8 at 3-months was identified as a statistically significant marker for an almost 10-fold increase in odds of mental frailty at 12-months (OR: 9.869 [95% CI 3.100–31.417]; Nagelkerke R2 = 0.320, Figure 4). When using absolute depression, anxiety, and trauma scores at 3-months for a second model, an increase of one point on absolute depression score at 3-months resulted in an almost 1.4 increase in odds of mental frailty at 12-months after ICU-discharge (OR: 1.361 [95% CI 1.168–1.586]; Nagelkerke R2 = 0.386). 3.3.3 Impact of frailty on mental health-related quality of life Lastly, between-group univariate analyses indicated that at 3 and 12-months post-ICU, patients with mental frailty scored significantly lower for mental health-related domain scores of the RAND-36. Patients experiencing relevant symptoms of anxiety, depression, or trauma at 3-months, scored lower when it comes tomental health (MH; 68 [48−76] vs 88 [76−94]), impaired role functioning due to emotional problems (RE; 33 [0–67] vs 100 [67–100]), energy/fatigue (EF; 40 [30−55] vs 65 [55−75]), and social functioning (SF; 50 [38–75] vs 88 [63–100]) (p < 0.001). Similar patterns were observed at 12-months where frail patients scored significantly lower with regards to mental HRQoL (Figure 5). Figure 3. Absolute scores in depression (HADS-D), anxiety (HADS-A), and trauma (TSQ) (median, 95% CI) for patients with or without mental frailty combined with caregiver strain (CSI) and caregiver trauma (TSQ-P) at 3 (black) and 12 (red)-months. Dotted line, threshold TSQ; interrupted line, threshold CSI; continuous line, threshold HADS. ** p < 0.01 *** p < 0.001 HADS-D HADS-A TSQ CSI TSQ-P 0 5 10 15 20 No mental frailty Total score ✱✱ HADS-D HADS-A TSQ CSI TSQ-P Mental frailty ✱✱✱ ✱✱✱ ✱✱✱
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