Functional status after intensive care: a challenge for rehabilitation professionals to improve outcome.
OBJECTIVE
To examine restrictions in daily functioning from a rehabilitation perspective in patients one year after discharge from the intensive care unit, and to identify prognostic factors for functional status.


METHODS
Cross-sectional design.


METHODS
Consecutive patients who were admitted to the intensive care unit for more than 48 h (n = 255).


METHODS
One year after intensive care, functional status (Sickness Impact Profile) as primary outcome, and Quality of Life (SF-36), anxiety and depression (Hospital Anxiety Depression Scale), and post-traumatic stress disorder (Impact of Events Scale) were evaluated.


RESULTS
Fifty-four percent of the patients had restrictions in daily functioning. Walking and social activities were most frequently restricted (30-60% of the patients). Quality of life was lower than the general Dutch population. Symptoms of anxiety and depression were found in 14%, and post-traumatic stress disorder in 18%. Severity of illness at admission and length of stay in the intensive care unit were identified as prognostic factors, although they explained only 10% of functional status.


CONCLUSIONS
The high prevalence of long-lasting restrictions in physical, social and psychological functioning among patients who stayed in the intensive care unit for at least 2 days implies that these patients are a potential target population for rehabilitation medicine. Multidisciplinary therapies need to be developed and evaluated in order to improve outcome.
van der Schaaf
Marike
M
Department of Rehabilitation, Academic Medical Center, University of Amsterdam, PO Box 22660, NL-1100 DD Amsterdam, The Netherlands. m.vanderschaaf@amc.uva.nl
Beelen
Anita
A
Dongelmans
Dave A
DA
Vroom
Margreeth B
MB
Nollet
Frans
F
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003422:Critical Care; D016638:Critical Illness / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D011379:Prognosis; D011788:Quality of Life; D018434:Sickness Impact Profile; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult