title: The Academic Medical Center Linear Disability Score for evaluation of physical reserve on admission to the ICU: can we query the relatives?
abstract: BACKGROUND
  Evaluating the pre-morbid functional status in critically ill patients is important and frequently done using the physical component score (PCS) of the Short Form 36, although this approach has its limitations. The Academic Medical Center Linear Disability Score (ALDS) is a recently developed generic item bank used to measure the disability status of patients with a broad range of diseases. We aimed to study whether proxy scoring with the ALDS could be used to assess the patients' functional status on admission for cardiac care unit (CCU) or ICU patients and how the ALDS relates to the PCS using the Short Form 12 (SF-12).
  
  
  METHODS
  Patients and proxies completed the ALDS and SF-12 score in the first 72 hours following ICU scheduled surgery (n = 14), ICU emergency admission (n = 56) and CCU emergency admission (n = 70).
  
  
  RESULTS
  In all patients (n = 140) a significant intra-class correlation was found for the ALDS (0.857), the PCS (0.798) and the mental component score (0.679) between patients and their proxy. In both scheduled and emergency admissions, a significant correlation was found between patients and their proxy for the ALDS, although the lowest correlation was found for the ICU scheduled admissions (0.755) compared with the ICU emergency admissions (0.889). In CCU patients, the highest significant correlation between patients and proxies was found for the ALDS (0.855), for the PCS (0.807) and for the mental component score (0.740).
  
  
  CONCLUSIONS
  Relatives in close contact with critically ill patients can adequately reflect the patient's level of disability on ICU and CCU admission when using the ALDS item bank, which performed at least as well as the PCS. The ALDS could therefore be a useful alternative for the PCS of the SF-12.
authors.affiliation: Department of Intensive Care, Gelre Hospital, Apeldoorn, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, the Netherlands. j.hofhuis@gelre.nl
authors.forename: José G M
authors.initials: JG
authors.lastname: Hofhuis
authors.forename: Marcel G W
authors.initials: MG
authors.lastname: Dijkgraaf
authors.forename: Aly
authors.initials: A
authors.lastname: Hovingh
authors.forename: Richard L
authors.initials: RL
authors.lastname: Braam
authors.forename: Lisa
authors.initials: L
authors.lastname: van de Braak
authors.forename: Peter E
authors.initials: PE
authors.lastname: Spronk
authors.forename: Johannes H
authors.initials: JH
authors.lastname: Rommes
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006757:Hospital Units; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010808:Physical Examination / Q000379:methods*; D019727:Proxy; D015203:Reproducibility of Results