Abstract Introduction One in three survivors of critical illness experience depression. We know that clinical factors such as severity of illness contribute to post-critical illness depression; however, less is known about the role of social factors such as support networks and financial resources. Methods Secondary analysis of data from LIFT2, a factorial randomized clinical trial of a mindfulness intervention conducted at three health systems in North Carolina, Oregon, and Colorado between August 2019 to July 2023. The trial enrolled adult survivors of cardiorespiratory failure who required care in an intensive care unit (ICU) and were subsequently discharged home. Outcomes were the baseline (in-hospital) PHQ-9 score and the difference between the post-discharge 1- and 3-month PHQ-9 scores. Higher scores indicate worse depressive symptoms. We fit nested generalized linear models to: (1) test the association between patients’ sociodemographic characteristics and clinical characteristics, separately, and the outcomes, and (2) assess the fit of nested models in comparison to a base model using likelihood ratio tests (less negative value indicates better fit). Covariates included in models are shown in the Table. Results We included 225 patients with a median age of 52 years (Q1, Q3: 38, 63) and a male preponderance (n = 130, 58%) who were in an ICU for a median of 4 days (Q1, Q3: 2, 6). For both outcomes, base models including only sociodemographic characteristics or clinical characteristics performed similarly (baseline PHQ-9: log likelihood = -610 and -606, respectively; 1-to-3-month change in PHQ-9: log likelihood = -955 and -961, respectively). The addition of age, sex, and clinical characteristics to the base sociodemographic models further` improved model fit in both cases (baseline PHQ-9: log likelihood = -582, p 0.001; 1-to-3-month change in PHQ-9: log likelihood = -942, p 0.01). The covariates with the strongest associations with lower baseline PHQ-9 scores (fewer depressive symptoms) were social support, financial comfort, and independence in more ADLs, and with greater positive change 1-to-3-month in PHQ-9 scores (worsening depression) were having an existing psychiatric condition requiring treatment and an existing mindfulness practice. Conclusions Social factors contribute significantly to both baseline depressive symptoms and post-discharge trajectories of change in depressive symptoms. Measuring social drivers of health may be necessary for effective detection and treatment of post-ICU psychological distress. This abstract is funded by: NIH
Ashana et al. (Fri,) studied this question.