In intensive care units, prediction of morbidity and mortality is usually based on composite physiological scores. Given that patients’ emotional response to stress is also controlled by physiological systems, integrating emotional responses into this assessment might improve clinicians’ accuracy in predicting deterioration in a patient’s condition.

Mazeraud and colleagues examined the association between patients’ fears and anxiety on admission to the intensive care unit and new organ failure or death within 7 days after admission. They found that

  • About half (51%) of patients reported mild to severe anxiety.

  • Fears expressed by patients included fear of intubation (64%), feeling vulnerable (54%), fear of becoming disabled (53%), and being afraid of dying (46%).

  • Patients with new organ failure were more likely to have feelings of vulnerability and were less likely to be afraid of dying.

Although further study is warranted, these findings support a causal relationship between physiological and psychological measures in...

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