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.
Department of Rehabilitation, Academic Medical Center, University of Amsterdam, PO Box 22660, NL-1100 DD Amsterdam, The Netherlands. m.vanderschaaf@amc.uva.nl
Marike
M
van der Schaaf
Anita
A
Beelen
Dave A
DA
Dongelmans
Margreeth B
MB
Vroom
Frans
F
Nollet
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