title: Complicated grief after death of a relative in the intensive care unit.
abstract: An increased proportion of deaths occur in the intensive care unit (ICU). We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months. Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives). End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements.
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Nancy
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authors.lastname: Kentish-Barnes
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Marine
authors.initials: M
authors.lastname: Chaize
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Valérie
authors.initials: V
authors.lastname: Seegers
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Legriel
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Alain
authors.initials: A
authors.lastname: Cariou
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Samir
authors.initials: S
authors.lastname: Jaber
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Lefrant
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Bernard
authors.initials: B
authors.lastname: Floccard
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Anne
authors.initials: A
authors.lastname: Renault
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vinatier
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Armelle
authors.initials: A
authors.lastname: Mathonnet
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Danielle
authors.initials: D
authors.lastname: Reuter
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Olivier
authors.initials: O
authors.lastname: Guisset
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Zoé
authors.initials: Z
authors.lastname: Cohen-Solal
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Christophe
authors.initials: C
authors.lastname: Cracco
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Amélie
authors.initials: A
authors.lastname: Seguin
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Jacques
authors.initials: J
authors.lastname: Durand-Gasselin
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Éon
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Marina
authors.initials: M
authors.lastname: Thirion
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Rigaud
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Philippon-Jouve
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Laurent
authors.initials: L
authors.lastname: Argaud
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Renaud
authors.initials: R
authors.lastname: Chouquer
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Adda
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Céline
authors.initials: C
authors.lastname: Dedrie
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Hugues
authors.initials: H
authors.lastname: Georges
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Eddy
authors.initials: E
authors.lastname: Lebas
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rolin
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Bollaert
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Lucien
authors.initials: L
authors.lastname: Lecuyer
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Gérard
authors.initials: G
authors.lastname: Viquesnel
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Marc
authors.initials: M
authors.lastname: Léone
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Ludivine
authors.initials: L
authors.lastname: Chalumeau-Lemoine
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Maïté
authors.initials: M
authors.lastname: Garrouste
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Benoit
authors.initials: B
authors.lastname: Schlemmer
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section.
authors.forename: Bruno
authors.initials: B
authors.lastname: Falissard
authors.affiliation: For a list of the authors' affiliations see the Acknowledgements section elie.azoulay@sls.aphp.fr.
authors.forename: Élie
authors.initials: É
authors.lastname: Azoulay
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis; D003142:Communication; D003422:Critical Care / Q000379:methods*; D003643:Death; D003863:Depression / Q000175:diagnosis; D005190:Family; D005260:Female; D006117:Grief; D006801:Humans; D007362:Intensive Care Units; D007440:Intubation; D008297:Male; D025341:Principal Component Analysis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis; D016312:Treatment Refusal