Critical Care volume 29,
Article number: 179 (2025) Published: 06 May 2025
Background
Many patients who survive intensive care unit (ICU) stays
experience persistent mental impairments. It is estimated that one-third of ICU
survivors suffer from psychiatric disorders. However, research into how these
disorders affect long-term outcomes in this population is scarce. Therefore,
the aim of this study is to investigate the association between depression or
anxiety and long-term mortality among ICU survivors.
Methods
This population-based cohort study included patients
admitted to the ICU between January 1, 2015 and December 31, 2019, who survived
at least 1 year after ICU discharge. Exclusions were made for patients
admitted for non-medical reasons and those who had been in the ICU in the
previous 2 years, and 799,645 patients were included in the study.
Follow-up data were obtained for up to 7 years. The primary outcome was
long-term cumulative mortality. Mortality rates for patients with and without
diagnoses of depression or anxiety were compared.
Results
Of the 799,645 adult ICU survivors, 98,530 (12.3%) were
newly diagnosed with depression or anxiety post-discharge, and 265,092 (33.2%)
had been diagnosed prior to ICU admission. Multivariate Cox proportional
hazards regression analysis revealed that the adjusted hazard ratio (HR) for
long-term mortality was 1.17 (95% CI, 1.16–1.19) for those newly diagnosed with
depression or anxiety, 1.28 (95% CI, 1.26–1.30) for depression alone, and 1.08
(95% CI, 1.06–1.11) for anxiety alone. For those with prior diagnoses, the
adjusted HR was 1.08 (95% CI, 1.07–1.09) overall, 1.12 (95% CI, 1.11–1.14) for
depression, and 1.04 (95% CI, 1.03–1.05) for anxiety.
Conclusions
ICU survivors newly diagnosed with depression or anxiety
exhibit higher long-term mortality rates compared to those without such
diagnoses, including those diagnosed before ICU admission. Particularly, newly
diagnosed depression is associated with an elevated mortality rate. These
findings underscore the need for psychological interventions to enhance
long-term survival among ICU survivors.
