Determination of functional prognosis in hospitalized patients following an intensive care admission

作     者：Natália A Ferreira Agnaldo José Lopes Arthur S Ferreira George Ntoumenopoulos Jerffesson Dias Fernando S Guimaraes 

作者机构：Rehabilitation Sciences Post-Gradua-tion Program Augusto Motta University Centre Physical Therapy Department Barra D’Or Hospital Post-Graduation Program in Medical Sciences State University of Rio de Janeiro Graduate School of Health Sciences University of Technology Sydney Physical Therapy Department Federal University of Rio de Janeiro 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2016年第5卷第4期

页      面：219-227页

学科分类：1011[医学-护理学（可授医学、理学学位）] 10[医学] 

主　　题：Muscle strength Intensive care units Activities of daily living Rehabilitation Early mobilization Post-intensive care unit syndrome 

摘      要：AIM To investigate the factors associated with the functional progress of hospitalized patients following an intensive care *** Retrospective study including data from a cohort of 198 hospitalized patients following an intensive care admission and not requiring mechanical ventilation in a single tertiary referral hospital. A generalized linear model was used to identify the main effects of clinical and demographic variables on the outcomes of functionality(KATZ Index of Independence in Activities of Daily Living) and muscle strength(MRC Scale). The covariates identified as independent predictors were analysed using the receiver operating characteristic curves. The analysis differentiated the periods in the intensive care unit(ICU), in the Ward(WARD) and the total time of hospital stay(TOT).RESULTS Considering the functional outcome(ΔKATZ), the variables that significantly contributed to the model(P 0.05) were the KATZ and MRC on admission, age, sepsis(no), and total length of stay(TLS). Regarding the muscle strength outcome model(ΔMRC), the predictors were MRC on admission, Simplified Acute Physiology Score III, previous stroke, TLS, and sex(female). The variable age(AUC = 0.664) discriminated the ΔKATZICU. The variables age(AUC = 0.712), KATZ in ICU(AUC = 0.590) and on ward admission(AUC = 0.746), and MRC on ward admission(AUC = 0.721) were discriminative for ΔKATZWARD. For ΔKATZTOT the variables KATZ on ICU admission(AUC = 0.621) and TLS(AUC = 0.617) were discriminative. For ΔMRCICU the variables SAPSIII(AUC = 0.661) and MRC on ICU admission(AUC = 0.653) were discriminative. MRC on ICU(AUC = 0.681) and ward admission(AUC = 0.553) were discriminative for ΔMRCWARD. TLS(AUC = 0.649) and MRC on ward admission(AUC = 0.696) discriminative for the Δ*** Specific functional, clinical and demographical variables at ICU admission are associated with the functional prognosis during the hospitalization period.