title: Fatigue in intensive care survivors one year after discharge.
abstract: BACKGROUND
  Fatigue has not been investigated in long-term Intensive Care Unit (ICU) survivors. This study aimed to assess fatigue through a specific instrument, namely the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scale, in ICU survivors one year after hospital discharge. A secondary aim was to compare the findings of FACIT-F with those of the Vitality domain (VT) of the 36-item Short-Form Health Survey (SF-36).
  
  
  METHODS
  This prospective cohort study was performed on 56 adult patients with a Length Of Stay (LOS) in ICU longer than 72 h. At one year after hospital discharge, FACIT-F and SF-36 questionnaires were administered to consenting patients by direct interview. FACIT-F was measured as raw (range 0-52), and FACIT-F-trans value (range 0-100). Past medical history, and demographic and clinical ICU-related variables were collected.
  
  
  RESULTS
  The patients' median age was 67.5, Simplified Acute Physiology Score II 31, and LOS in ICU 5 days. The median raw FACIT-F of the patients was 41, and Cronbach's α was 0.937. The correlation coefficient between FACIT-F-trans and VT of SF-36 was 0.660 (p < 0.001). Both FACIT-F and VT were related to dyspnoea scale (p = 0.01). A Bland-Altman plot of VT vs FACIT-F-trans showed a bias of -0.8 with 95 % limits of agreement from 35.7 to -34.1. The linear regression between differences and means was 0.639, suggesting a significant proportional bias.
  
  
  CONCLUSIONS
  The 13-item FACIT-F questionnaire is valid to assess fatigue of long-term ICU survivors. VT of SF-36 relates to FACIT-F, but consists of only four items assessing two positive and two negative aspects. FACIT-F grasps the negative aspects of fatigue better than VT. Specific tools assess specific conditions better that general tools.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT02684877 .
authors.affiliation: Department of Morphology, Experimental Medicine and Surgery, Section of Anaesthesia and Intensive Care, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Via Aldo Moro, 8. 44121, Cona, Ferrara, Italy. savinospadaro@gmail.com.
authors.forename: Savino
authors.initials: S
authors.lastname: Spadaro
authors.affiliation: Department of Morphology, Experimental Medicine and Surgery, Section of Anaesthesia and Intensive Care, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Via Aldo Moro, 8. 44121, Cona, Ferrara, Italy.
authors.forename: Maurizia
authors.initials: M
authors.lastname: Capuzzo
authors.affiliation: Research and Innovation Office, Azienda Ospedaliero-Universitaria S. Anna, Cona, Ferrara, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Valpiani
authors.affiliation: Department of Morphology, Experimental Medicine and Surgery, Section of Anaesthesia and Intensive Care, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Via Aldo Moro, 8. 44121, Cona, Ferrara, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Bertacchini
authors.affiliation: Department of Morphology, Experimental Medicine and Surgery, Section of Anaesthesia and Intensive Care, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Via Aldo Moro, 8. 44121, Cona, Ferrara, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ragazzi
authors.affiliation: Department of Morphology, Experimental Medicine and Surgery, Section of Anaesthesia and Intensive Care, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Via Aldo Moro, 8. 44121, Cona, Ferrara, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Dalla Corte
authors.affiliation: Department of Morphology, Experimental Medicine and Surgery, Section of Anaesthesia and Intensive Care, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Via Aldo Moro, 8. 44121, Cona, Ferrara, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Terranova
authors.affiliation: Department of Morphology, Experimental Medicine and Surgery, Section of Anaesthesia and Intensive Care, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Via Aldo Moro, 8. 44121, Cona, Ferrara, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Marangoni
authors.affiliation: Department of Morphology, Experimental Medicine and Surgery, Section of Anaesthesia and Intensive Care, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Via Aldo Moro, 8. 44121, Cona, Ferrara, Italy.
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Volta
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003422:Critical Care; D005221:Fatigue / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013997:Time Factors
keywords: FACIT-F scale; Fatigue; Intensive care; Outcome; Quality of life