Poor functional status immediately after discharge from an intensive care unit.
OBJECTIVE
To evaluate the functional status of patients within the first week of discharge from an intensive care unit (ICU), and to identify predictors and explanatory factors of functional status.


METHODS
A prospective, observational, cohort study was conducted with consecutive ICU patients who had stayed in a mixed, closed-format, university-level ICU for longer than 48 h.


RESULTS
Between 3 and 7 days of discharge from the ICU, functional status (as primary outcome), walking ability, muscle strength, and sensory and cognitive functioning were assessed in 69 survivors. The overall functional status was poor (median Barthel Index 6). In their ability to perform basic activities of daily living, 67% percent were severely dependent, 15% were moderately dependent, and 9% were slightly dependent on other people. Independent walking was impossible for 73% of participants, grip strength was reduced for 50%, and 30% had cognitive impairments. Duration of ventilation was associated with functional status after ICU discharge. Reduced grip strength and walking ability were identified as explanatory factors for poorer functional status shortly after discharge from the ICU.


CONCLUSIONS
In the first week after discharge from the ICU, the majority of the patients had substantial functional disabilities in activities of daily living. These disabilities were more severe in patients who experienced ventilation for a longer period of time. There is a need for prospective studies focusing on functional recovery to support informed decision-making concerning the care of critically ill patients after ICU discharge.
van der Schaaf
Marike
M
Department of Rehabilitation, Academic Medical Center, University of Amsterdam, The Netherlands. m.vanderschaaf@amc.uva.nl
Dettling
Daniela S
DS
Beelen
Anita
A
Lucas
Cees
C
Dongelmans
Dave A
DA
Nollet
Frans
F
D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D003266:Continuity of Patient Care; D003422:Critical Care / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D012720:Severity of Illness Index