title: Factors Associated with Functional Recovery among Older Intensive Care Unit Survivors.
abstract: Most of the 1.4 million older adults who survive the intensive care unit (ICU) annually in the United States face increased disability, but little is known about those who achieve functional recovery.
  
  
  
  Our objectives were twofold: to evaluate the incidence and time to recovery of premorbid function within 6 months of a critical illness and to identify independent predictors of functional recovery among older ICU survivors.
  
  
  
  Potential participants included 754 persons aged 70 years or older who were evaluated monthly in 13 functional activities (1998-2012). The analytic sample included 218 ICU admissions from 186 ICU survivors. Functional recovery was defined as returning to a disability count less than or equal to the pre-ICU disability count within 6 months. Twenty-one potential predictors were evaluated for their associations with recovery.
  
  
  
  Functional recovery was observed for 114 (52.3%) of the 218 admissions. In multivariable analysis, higher body mass index (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.03-1.12) and greater functional self-efficacy (HR, 1.05; 95% CI, 1.02-1.08), a measure of confidence in performing various activities, were associated with recovery, whereas pre-ICU impairment in hearing (HR, 0.38; 95% CI, 0.22-0.66) and vision (HR, 0.59; 95% CI, 0.37-0.95) were associated with a lack of recovery.
  
  
  
  Among older adults who survived an ICU admission with increased disability, pre-ICU hearing and vision impairment were strongly associated with poor functional recovery within 6 months, whereas higher body mass index and functional self-efficacy were associated with recovery. Future research is needed to evaluate whether interventions targeting these factors improve functional outcomes among older ICU survivors.
authors: 1 Section of Pulmonary, Critical Care, and Sleep Medicine and.
authors: Lauren E
authors: 0000-0003-1345-1225
authors: LE
authors: Ferrante
authors: 1 Section of Pulmonary, Critical Care, and Sleep Medicine and.
authors: Margaret A
authors: MA
authors: Pisani
authors: 2 Section of Geriatrics, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
authors: Terrence E
authors: TE
authors: Murphy
authors: 2 Section of Geriatrics, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
authors: Evelyne A
authors: EA
authors: Gahbauer
authors: 2 Section of Geriatrics, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
authors: Linda S
authors: LS
authors: Leo-Summers
authors: 2 Section of Geriatrics, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
authors: Thomas M
authors: TM
authors: Gill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000534:rehabilitation*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D008137:Longitudinal Studies; D008297:Male; D020127:Recovery of Function; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors
keywords: Medicare; functional status; intensive care; quality of life