To identify predictors of poor long-term physical recovery in ICU survivors one year after ICU discharge.
We examined potential predictors for poor long-term physical recovery, with a secondary analysis of a trial of 50 patients who were intubated during their ICU stay and underwent mobilization, with one-year follow up. Linear regression analysis examined the associations of exposure variables (baseline characteristics; severity of illness variables; ICU-related variables; and lengths of ICU and hospital stay), with three physical recovery variables measured one year after ICU discharge (muscle strength (measured with Medical Research Council – Sum Score); exercise capacity (measured with the 6 Minute Walk Test); and self-reported physical function (measured with Short Form - 36v2, Physical Function domain)).
The sample consisted of 33 males with a median (IQR) age of 62 (54-73) years and 17 females with a median (IQR) age of 63 (60-71) years. All were ambulating and independent in activities of daily living before the onset of their critical illnesses. When the data was adjusted for age, female gender was associated with lower muscle strength (p=.003), lower exercise capacity (p.0001) and worse self-reported physical function (p=.01) than males, one year after discharge from the ICU. Older age, when adjusted for gender was associated with lower exercise capacity (p=.001) one year after discharge from the ICU. After adjusting for gender and age, an association was observed between a lower score on one or two physical recovery variables measured one year after ICU discharge, and six exposure variables, specifically: High body mass index at baseline; low functional independence at baseline (measured with Modified Barthel Index); functional comorbidity at baseline (measured with Functional Comorbidity Index); low self-reported physical function at baseline (measured with Short Form - 36v2, Physical Function domain); muscle weakness at ICU discharge and longer hospital stay. No adjustment was made for cumulative type I error rate due to small number of participants.
Female gender is significantly associated with poor physical recovery one year after ICU discharge. The baseline variables high body mass index, low functional independence, functional comorbidity and low self-reported physical function are associated with poor physical recovery one year after ICU discharge, as well as muscle weakness at ICU discharge, and longer hospital stay.
Elucidation of the trajectory of physical recovery after critical illness could augment early intervention for at-risk patients, thereby improving their long-term functional recovery.
physical recovery after critical illness
Post Intensive Care Syndrome
