Review Article| Volume 59, P1-7, May 2023

Effect size estimates of risk factors for post-intensive care syndrome-family: A systematic review and meta-analysis

Published:January 13, 2023DOI:


      • This review examined risk factors for post-intensive care syndrome-family, and history of mental illness had the largest effect size that increased the risk of post-intensive care syndrome-family.
      • Poor communication with intensive care unit staff was identified as a risk factor attributable to the psychosocial experiences of families, many such modifiable risk factors have not been identified.
      • Additional studies are needed to further clarify and identify modifiable risk factors for the post-intensive care syndrome-family to provide stronger evidence.



      Families of patients admitted to ICUs often experience post-intensive care syndrome-family, and previous studies have reported several possible risk factors. However, to date, no meta-analyses have been conducted on the numerous risk factors associated with the development of post-intensive care syndrome-family and how strongly these factors are in association with post-intensive care syndrome-family.


      To identify risk factors for post-intensive care syndrome-family and determine the effect size of individual risk factors.


      This systematic review used MEDLINE, CINAHL, PsycINFO, and EMBASE databases to search all studies through December 1, 2021, that reported risk factors for anxiety, depression, PTSD, and prolonged grief disorder in the families of adult patients in ICUs. A meta-analysis was conducted to calculate an overall estimate for key risk factors, and odds ratio and 95% confidence intervals were used as summary statistics using the random-effects model.


      Of 2964 identified studies, 17 were included. Nine factors for anxiety, eight for depression, and three for PTSD were assessed using results from 13 studies. The risk factor with the largest effect size was “history of mental illness,” which, along with “female sex,” was a significant risk factor common to anxiety, depression, and PTSD. “Poor communication with ICU staff,” “severely ill patient,” and “patients’ spouse” were common risk factors for anxiety and depression.


      We identified several risk factors related to patient and family demographic characteristics. Further research is required to identify and validate modifiable risk factors for the psychosocial experiences of families of ICU patients.


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