Predictive variables for poor long‐term physical recovery after intensive care unit stay: An exploratory study

Abstract

In recent years, ICU research has increasingly focused on understanding factors that influence patients' recovery and how long-term outcomes can be maximized. 9,10 ICU patients are heterogeneous, thus their trajectory of physical recovery is diverse. 1,11 Gender, 1,11,12 older age, 1,2,11,13,14 comorbidity, 2,15 duration of continuous sedation, 11 duration of bed rest, 6,16 and ICU length of stay (LOS), 11,13,16 have all been reported to impact the physical recovery of ICU survivors. Men have been reported to experience better physical recovery after critical illness than women. 1,12 Younger women with a shorter duration of sedation and

Patients With and Without COVID-19 in the Intensive Care Unit: Physical Status Outcome Comparisons 3 Months After Discharge

“…In the non–COVID-19 ICU patient population, it is known that muscle strength and physical functioning increase mainly in the first 3 months and flatten between 3 and 6 months. 46 , 47 It is possible that differences existed in the first 3 months because of an older age, 9 , 10 a longer ICU length of stay, 10 and a longer duration of mechanical ventilation, 48 but these possible differences were no longer present at the time of measurement. Furthermore, our data showed that physical functioning and health status of patients in the COVID-19 ICU group were lower than in healthy people approximately 3 months after ICU discharge.…”

“…For the secondary study aim, the following potential determinants for postdischarge physical status of the COVID-19 ICU group were selected based on earlier studies: age 9 , 10 , 30 (continuous), sex 10 , 30 (reported as male/female), BMI, 10 , 31 comorbidities in medical history, 9 , 10 , 30 and premorbid function 9 , 10 at ICU admission. BMI was calculated according to the continuous variable Quetelet Index.…”

“…The severity of illness was scored with the Acute Physiology And Chronic Health Evaluation (APACHE) IV score. 10 The APACHE IV score is a method for predicting hospital mortality among adults who are critically ill. Furthermore, the duration of mechanical ventilation, 9 , 35 ICU length of stay, and hospital length of stay 35 were recorded in days, and organ dysfunction was measured with the Sequential Organ Failure Assessment score.…”

“… 7 , 8 Known possible predictive variables for poor physical recovery after ICU stay are older age, female sex (reported as male/female), a high body mass index (BMI), presence of comorbidities, a low self-reported premorbid function, and a higher severity of illness. 9 , 10 Rehabilitation seems to be a cornerstone in the management of PICS during all phases of recovery, starting at the ICU admission, 11 continuing on the general hospital ward, and after hospital discharge. 12 However, a Cochrane review, focusing on rehabilitation after hospital discharge, did not show an effect on physical functioning due to low study quality.…”

Attenuating Muscle Mass Loss in Critical Illness: the Role of Nutrition and Exercise

“…The ICU population is a highly heterogeneous population in terms of admission diagnoses and comorbid health statuses. Pre-ICU health factors such as comorbidities, age, sex and baseline nutritional status are likely to impact the response to exercise and nutrition, as well as the post-ICU recovery trajectory [96]. Therefore, a personalised approach to nutrition and exercise delivery may be needed with the identification of subgroups who may respond to different therapies and dosage levels.…”