Long-term functional disabilities in intensive care unit survivors : A prospective cohort study
Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Functional disabilities are common in intensive care unit (ICU) survivors and may affect their ability to live independently. Few previous studies have investigated long-term functional outcomes with health status before ICU admission (pre-ICU health), and they are limited to specific patient groups.
OBJECTIVES: The objective of this study was to investigate the prevalence of functional disabilities and examine pre-ICU health variables as possible predictive factors of functional disabilities 12 months after ICU admission in a mixed population of ICU survivors.
METHODS: This prospective cohort study was conducted in six ICUs in Norway. Data on pre-ICU health were collected as soon as possible after ICU admission using patients, proxies, and patient electronic health records and at 12 months after ICU admission. Self-reported functional status was assessed using the Katz Index of independence in personal activities of daily living (P-ADL) and the Lawton instrumental activities of daily living scale (I-ADL).
RESULTS: A total of 220 of 343 (64%) ICU survivors with data on pre-ICU health completed the questionnaires at 12 months and reported the following functional disabilities at 12 months: 31 patients (14.4%) reported P-ADL dependencies (new in 16 and persisting in 15), and 80 patients (36.4%) reported I-ADL dependencies (new in 41 and persisting in 39). In a multivariate analysis, worse baseline P-ADL and I-ADL scores were associated with dependencies in P-ADLs (odds ratio [OR]: 1.87; 95% confidence interval [CI]: 1.14-3.06) and I-ADLs (OR: 1.52; 95% CI: 1.03-2.23), respectively, at 12 months. Patients who were employed were less likely to report I-ADL dependencies at 12 months (OR: 0.34; 95% CI: 0.12-0.95).
CONCLUSION: In a subsample of ICU survivors, patients reported functional disabilities 12 months after ICU admission, which was significantly associated with their pre-ICU functional status. Early screening of pre-ICU functional status may help identify patients at risk of long-term functional disabilities. ICU survivors with pre-ICU functional disabilities may find it difficult to improve their functional status.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Australian critical care : official journal of the Confederation of Australian Critical Care Nurses - (2024) vom: 02. Jan. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mesina, Renato S [VerfasserIn] |
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| Links: |
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| Themen: |
Activities of daily living |
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| Anmerkungen: |
Date Revised 03.01.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.aucc.2023.11.008 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366626043 |
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| 041 | |a eng | ||
| 100 | 1 | |a Mesina, Renato S |c Jr |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-term functional disabilities in intensive care unit survivors |b A prospective cohort study |
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| 500 | |a Date Revised 03.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Functional disabilities are common in intensive care unit (ICU) survivors and may affect their ability to live independently. Few previous studies have investigated long-term functional outcomes with health status before ICU admission (pre-ICU health), and they are limited to specific patient groups | ||
| 520 | |a OBJECTIVES: The objective of this study was to investigate the prevalence of functional disabilities and examine pre-ICU health variables as possible predictive factors of functional disabilities 12 months after ICU admission in a mixed population of ICU survivors | ||
| 520 | |a METHODS: This prospective cohort study was conducted in six ICUs in Norway. Data on pre-ICU health were collected as soon as possible after ICU admission using patients, proxies, and patient electronic health records and at 12 months after ICU admission. Self-reported functional status was assessed using the Katz Index of independence in personal activities of daily living (P-ADL) and the Lawton instrumental activities of daily living scale (I-ADL) | ||
| 520 | |a RESULTS: A total of 220 of 343 (64%) ICU survivors with data on pre-ICU health completed the questionnaires at 12 months and reported the following functional disabilities at 12 months: 31 patients (14.4%) reported P-ADL dependencies (new in 16 and persisting in 15), and 80 patients (36.4%) reported I-ADL dependencies (new in 41 and persisting in 39). In a multivariate analysis, worse baseline P-ADL and I-ADL scores were associated with dependencies in P-ADLs (odds ratio [OR]: 1.87; 95% confidence interval [CI]: 1.14-3.06) and I-ADLs (OR: 1.52; 95% CI: 1.03-2.23), respectively, at 12 months. Patients who were employed were less likely to report I-ADL dependencies at 12 months (OR: 0.34; 95% CI: 0.12-0.95) | ||
| 520 | |a CONCLUSION: In a subsample of ICU survivors, patients reported functional disabilities 12 months after ICU admission, which was significantly associated with their pre-ICU functional status. Early screening of pre-ICU functional status may help identify patients at risk of long-term functional disabilities. ICU survivors with pre-ICU functional disabilities may find it difficult to improve their functional status | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Activities of daily living | |
| 650 | 4 | |a Critical care | |
| 650 | 4 | |a Critical illness | |
| 650 | 4 | |a Disability | |
| 650 | 4 | |a Functional status | |
| 650 | 4 | |a Intensive care unit | |
| 650 | 4 | |a Longitudinal studies | |
| 650 | 4 | |a Post–intensive care syndrome | |
| 700 | 1 | |a Rustøen, Tone |e verfasserin |4 aut | |
| 700 | 1 | |a Hagen, Milada |e verfasserin |4 aut | |
| 700 | 1 | |a Laake, Jon Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Hofsø, Kristin |e verfasserin |4 aut | |
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