Basal functional status predicts functional recovery in critically ill patients with multiple-organ failure

Rodríguez-Villar, S.; Fernández-Méndez, Rocío; Adams, Gary G.; Rodríguez-García, J L; Arévalo-Serrano, Juan; Sánchez-Casado, M.; Kilgour, Peter

doi:10.1016/j.jcrc.2015.02.006

Cited by 14 publications

(10 citation statements)

References 34 publications

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“…They found that only 26% had good function at 6 months (mRS 0-2) but the proportion had increased to 66% by 12 months. Their analysis also showed that better functional status before admission, lower severity scores upon admission, and younger age were associated with good functional recovery [9]. These results are mostly consistent with our findings, which were derived from a larger population of older patients who were not required to have multi-organ failure for their inclusion.…”

Section: Discussionsupporting

confidence: 91%

“…Functional outcome after critical illness has been reported in several previous studies [1][2][3]5,9,12,26]. It is difficult to compare our findings with the results of previous research because of the differences in study population, method of functional assessment, and time of follow up.…”

Section: Discussionmentioning

confidence: 50%

“…Availability of cognitive outcomes in many survivors attenuates this concern. While the mRS has been mostly used in stroke trials and studies on patients with other acute brain diseases [10,[30][31][32], this tool has also been previously employed for the assessment of functional outcome after ICU hospitalization for multiorgan failure [9].…”

Section: Discussionmentioning

confidence: 99%

“…Data on post-ICU disability and its contributing factors are limited [3,7]. Furthermore, available studies were restricted to specific complications (ICU-acquired weakness, cognitive impairment, or behavioral disorders), specific populations [8][9][10][11], or specific age groups [12,13]. Several of these studies only evaluated individual prognosticators or had short follow-up after discharge [5,14].…”

Section: Introductionmentioning

confidence: 99%

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Functional outcome after critical illness in older patients: a population-based study

Hajeb

Singh

Sakusic

et al. 2020

Neurological Research

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Purpose: To determine the prevalence of disability among ICU survivors one year after admission, and which factors influence functional outcome. Methods: We examined consecutive patients enrolled in the population-based Mayo Clinic Olmsted Study of Aging and then admitted to medical or surgical adult ICUs at Mayo Clinic, Rochester between January 1, 2006, and December 31, 2014 to determine one-year functional outcomes. Results: 831cases were included. Mean age was 84 years (IQR 79-88). 569 (68.5%) patients were alive one year after ICU admission. Of them, 546 patients had functional assessment at one year and 367 (67.2%) had good functional outcome. On multivariable analysis, poor oneyear functional outcome (death or disability) was more common among women, older patients, and patients with baseline cognitive impairment (mild cognitive impairment or dementia), higher Carlson scores, and longer ICU stay (all P <.01). After excluding deceased patients, these associations remained unchanged. In addition, 120 (32.3%) of 372 patients who had post-ICU cognitive evaluation experienced cognitive decline after the ICU admission. Conclusions: On a population-based cohort of older, predominantly elderly patients, approximately two-thirds of survivors maintained or regained good functional status 1 year after ICU hospitalization. However, older age, female sex, greater comorbidities, abnormal baseline cognition, and longer ICU stay were associated with poor functional recovery and cognitive decline was common.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Functional outcome after critical illness in older patients: a population-based study

Hajeb

Singh

Sakusic

et al. 2020

Neurological Research

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“…Pre-ICU functional disability in basic, instrumental, and mobility activities is associated with a heightened mortality in the year following ICU admission (48). Further, self-perceived functional status of ICU survivors 6 and 12 months following hospital discharge is associated with self-perceived basal functional status determined at ICU admission (57). Additionally, frailty is an important driver of ICU survivorship and out of hospital outcomes (54, 58) and likely influences functional status at hospital discharge.…”

Section: Discussionmentioning

confidence: 99%

Functional Status in ICU Survivors and Out of Hospital Outcomes

Rydingsward

Horkan

Mogensen

et al. 2016

Critical Care Medicine

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Objective Functional status at hospital discharge may be a risk factor for adverse events among survivors of critical illness. We sought to examine the association between functional status at hospital discharge in survivors of critical care and risk of 90-day all-cause mortality after hospital discharge. Design Single center retrospective cohort study Setting Academic Medical Center Patients 10,343 adults who received critical care from 1997 to 2011 and survived hospitalization. Interventions None Measurements and Main Results The exposure of interest was functional status determined at hospital discharge by a licensed physical therapist and rated based on qualitative categories adapted from the Functional Independence Measure. The main outcome was 90-day post hospital discharge all-cause mortality. A categorical risk prediction score was derived and validated based on a logistic regression model of the function grades for each assessment. In an adjusted logistic regression model, the lowest quartile of functional status at hospital discharge was associated with an increased odds of 90-day post-discharge mortality compared to patients with independent functional status [OR=7.63 (95%CI 3.83, 15.22; P<0.001)]. In patients who had at least seven days of physical therapy treatment prior to hospital discharge (N=2,293), the adjusted odds of 90-day post-discharge mortality in patients with marked improvement in functional status at discharge was 64% less than patients with no change in functional status [OR 0.36 (95%CI 0.24–0.53); P<0.001]. Conclusions Lower functional status at hospital discharge in survivors of critical illness is associated with increased post-discharge mortality. Further, patients whose functional status improves before discharge have decreased odds of post-discharge mortality.

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Relationship of Age And Mobility Levels During Physical Rehabilitation With Clinical Outcomes in Critical Illness

Mayer,

Silva,

Beaty

et al. 2023

Archives of Rehabilitation Research and Clinical Translation

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Basal functional status predicts functional recovery in critically ill patients with multiple-organ failure

Cited by 14 publications

References 34 publications

Functional outcome after critical illness in older patients: a population-based study

Functional outcome after critical illness in older patients: a population-based study

Functional Status in ICU Survivors and Out of Hospital Outcomes

Relationship of Age And Mobility Levels During Physical Rehabilitation With Clinical Outcomes in Critical Illness

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