Poor functional recovery after a critical illness: a longitudinal study.
OBJECTIVE
To determine the time course of functional health status, and to inventory impairments in body functions, limitations in activities, and restrictions in participation after critical illness.


METHODS
Prospective observational cohort study.


METHODS
Mixed medical and surgical closed format; intensive care unit of an academic medical hospital.


METHODS
Consecutive patients over a period of 3 months who were ventilated in the intensive care unit for more than 48 h (n = 116).


METHODS
Functional health status was assessed 3, 6 and 12 months after discharge from the intensive care unit using the Sickness Impact Profile 68. Impairments in function, limitations in activities, and restrictions in participation, classified according to the International Classification of Functioning, Disability, and Health (ICF), were evaluated after 3 and 12 months.


RESULTS
Due to a high mortality rate (48%) and poor health conditions, data could not be obtained from all participants at all measurement points. Physical functioning and social behaviour improved predominantly within the first 6 months, while impaired psychological functioning remained unchanged within one year after discharge from the intensive care unit. After one year, 69% of patients were still restricted in performing daily activities and only 50% had resumed work.


CONCLUSIONS
The extent and severity of lasting intensive care unit-related disability necessitates the development of multidisciplinary after-care to improve health status, functional independence and return to work.
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; D000328:Adult; D000359:Aftercare; D000368:Aged; D015331:Cohort Studies; D003289:Convalescence; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality / Q000523:psychology / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D020127:Recovery of Function; D012050:Rehabilitation, Vocational; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult