IS THERE FUNCTIONAL INCREMENT AFTER DISCHARGE FROM THE ICU IN A UNIVERSITY HOSPITAL IN SOUTHERN BRAZIL?

dos Santos L.J.¹, Silveira F.S.¹, Muller F.F.¹, Araujo H.D.¹, Comerlato J.B.¹, da Silva M.C.¹, da Silva P.B.¹

¹Universidade Luterana do Brasil, Physical Therapy, Canoas, Brazil

Background: Critically ill patients, constantly exposed to prolonged imobilization, can demonstrate functional impairment. Identify those profiles, support the verification of a need for future early rehabilitation protocols, as well as the type of more effective intervention for each patient.

Purpose: Compare the functional profile in the ICU and on the hospital discharge in patients admitted at the University Hospital of Canoas / RS, Brazil.

Methods: Prospective cohort study quantitative conducted between March and October 2016 in the Adult Intensive Care Unit at the University Hospital of Canoas / RS, Brazil, with patients of both genders, with more than 24 hours of admission. They were excluded patients with neuromuscular or trauma/orthopedic disorders. The following were used assessment tools in the ICU and in the hospital: (1) Functional Independence Measure (FIM) in the evaluation of the functionality; (2) Medical Research Council (MRC) for rate the peripheral muscle strength; (3) Timed Up and Go for evaluation of mobility; (4) Six Minute Walk Test for identification of functional capacity; (5) Tinnetti Index for assessment of the balance. To compare the variables over time were applied the model Estimates of Generalized Equations (GEE) adjusted by Bonferroni.

Results: The sample included 90 patients (mean age 59.6±16.1 years and 51.1% male) on the study period. The median length of stay in ICU was 5 (3-9) days and, in the hospital, 13 (10-20) days. Prior to hospitalization, functionality median was 110 (74-125) points and at discharge from hospital, 126 (116-126) points (p 0.001). The peripheral muscle strength was 51.9±6.9 points and 53.6±7.4 points (p=0.002). The initial evaluation for mobility amounted to 14.4 (10-23) seconds and the final 9.9 (8-16) seconds (p=0.004). The distance walked in the ICU was 330 (245-390) meters and at discharge from hospital, 450 (382-476) meters (p 0.001). The balance in the ICU totaled 52 (44-55) points and the hospital 54 (50-57) points (p=0.009).

Conclusion(s): There was functional increment after discharge from the ICU at University Hospital in Canoas / RS, Brazil. It is suggested in future research, that patients are followed up in post discharge period.

Implications: The early rehabilitation protocol is promoting the functional increase on patients admitted at this hospital. It is necessary to correlate the values with predicted in the literature.

Funding acknowledgements: N/A

Topic: Critical care

Ethics approval: Approved by Ethics Committee of Universidade Luterana do Brazil (1.046.995).

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