Photo Credit: Frances Coch
The following is a summary of “Association of Lack of Fear of Dying With New Organ Failure: Results of a Multicenter Prospective Cohort Study,” published in the January 2024 issue of Critical Care by Mazeraud et al.
Researchers conducted a prospective study to investigate if patients’ fears and anxiety upon ICU admission predict the development of new organ failure within 7 days.
They involved a 3-center cohort study with non-comatose patients who didn’t have delirium or invasive mechanical ventilation. Nine specific fears were examined via yes/no questions. The severity of illness was measured using the Simplified Acute Physiology Score II (SAPS II) and the Sequential Organ Failure Assessment (SOFA). Acute and chronic anxiety levels were assessed using the state and trait components of the State-Trait Anxiety Inventory (STAI), and patients were monitored for 7 days.
The results showed 373 patients (median [IQR] age, 63 [48-74] years; 152 [40.8%] women; median (IQR) SAPS II, 27 [19-37]) from April 2014 to December 2017. Among them, 203 (54.4%) reported feelings of vulnerability, and 172 (46.1%) expressed fear of dying. The STAI-State score was 40 or higher in 192 patients (51.5%). Ninety-four patients (25.2%) developed new organ failure. Feelings of vulnerability (odds ratio, 1.96 [95% CI, 1.12-3.43]; P=.02) and absence of fear of dying (OR, 2.38 [95% CI, 1.37-4.17]; P=.002) were linked to new organ failure after adjusting for STAI-State score (≥40), SAPS II, and SOFA score.
They concluded that ICU patients who didn’t report fearing death were more likely to experience new organ failure within a week, suggesting fear may trigger protective responses that combat illness.
