Functional status after intensive care: a challenge for rehabilitation professionals to improve outcome

• Published in: Journal of rehabilitation medicine Vol. 41; no. 5; pp. 360 - 366
• Main Authors: van der Schaaf, Marike, Beelen, Anita, Dongelmans, Dave A, Vroom, Margreeth B, Nollet, Frans
• Format: Journal Article
• Language: English
• Published: Sweden 01-04-2009
• Subjects: Activities of Daily Living; Adolescent; Adult; Aged; Aged, 80 and over; Anxiety-Depression; Cohort Studies; Critical Care; Critical Illness - psychology; Critical Illness - rehabilitation; Critical Illness - therapy; Cross-Sectional Studies; Depression - etiology; Female; Functional status; Humans; Intensive care units; Male; Middle Aged; Outcome Assessment (Health Care); Patient Discharge; Posttraumatic stress disorder; Prognosis; Quality of Life; Rehabilitation; Sickness Impact Profile; Stress Disorders, Post-Traumatic - etiology; Surveys and Questionnaires; Time Factors; Young Adult
• ISSN: 1650-1977; 1651-2081
• DOI: 10.2340/16501977-0333

To examine restrictions in daily functioning from a rehabilitation perspective in patients one year after discharge from the intensive care unit, and to identify prognostic factors for functional status.
Cross-sectional design.
Consecutive patients who were admitted to the intensive care unit for more than 48 h (n = 255).
One year after intensive care, functional status (Sickness Impact Profile) as primary outcome, and Quality of Life (SF-36), anxiety and depression (Hospital Anxiety Depression Scale), and post-traumatic stress disorder (Impact of Events Scale) were evaluated.
Fifty-four percent of the patients had restrictions in daily functioning. Walking and social activities were most frequently restricted (30-60% of the patients). Quality of life was lower than the general Dutch population. Symptoms of anxiety and depression were found in 14%, and post-traumatic stress disorder in 18%. Severity of illness at admission and length of stay in the intensive care unit were identified as prognostic factors, although they explained only 10% of functional status.
The high prevalence of long-lasting restrictions in physical, social and psychological functioning among patients who stayed in the intensive care unit for at least 2 days implies that these patients are a potential target population for rehabilitation medicine. Multidisciplinary therapies need to be developed and evaluated in order to improve outcome.