Physical functional capacity and physical morbidity at discharge in critically ill patients who received mechanical mentilation: A descriptive observational study

To describe the levels of physical, functional capacity, and physical morbidity at discharge of critically ill patients who received MV in the ICU of the National University Hospital of Colombia during 2021-2022.

1. Describe the clinical, functional, and muscle strength characteristics of the patients.
2. Evaluate the frequency of physical morbidity using the Chelsea Critical Care Physical Assessment tool (CPAx).
3. Analyze the characteristics of patients with and without physical morbidity according to the CPAx scale.

A descriptive cross-sectional study was conducted. The population included patients over 18 years old who were admitted to the ICU for the first time and required MV. Patients with pre-existing neuromuscular diseases and those with insufficient clinical history information were excluded. Variables included age, sex, reason for admission, APACHE IV and SOFA scores, ICU stay days, and MV days, among others. The ICU Mobility Scale (IMS), CPAx, and Medical Research Council Sum Score (MRC-SS) scales were used to evaluate physical and functional capacity.

A total of 240 patients were evaluated, with an average age of 58.85 years. 55.83% were men. The main admission diagnosis was cardiovascular (25%). At discharge, 43.8% of patients had physical morbidity according to the CPAx scale. Patients with physical morbidity had a higher median MV days (7 days) compared to those without physical morbidity (4 days). Additionally, patients without physical morbidity showed better scores on the IMS and MRC-SS scales, indicating better functional capacity and lower risk of post-ICU syndrome (PICS).

Physical morbidity can be determined with the CPAx scale and is related to muscle strength and mobility level.

The levels of physical morbidity and ICUAW are similar to those reported in previous studies.

Patients with physical morbidity were exposed to more MV days and required ostomies in a higher proportion.

The observed levels of mobility and physical activity are encouraging in the Colombian context.

This study is pioneering in Colombia and highlights the role of physiotherapists in critical care.

This study highlights the importance of physiotherapy in critical care and the need for early mobilization strategies to improve patients’ functional capacity. The data obtained can guide future research to identify the critical subdomains of physical and functional capacity that should always be included in evaluations during ICU stay and throughout recovery.