Physical function impairment in survivors of critical illness in an ICU Recovery Clinic

• Published in: Journal of critical care Vol. 45; pp. 163 - 169
• Main Authors: Bakhru, Rita N., Davidson, James F., Bookstaver, Rebecca E., Kenes, Michael T., Welborn, Kristin G., Morris, Peter E., Clark Files, D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2018; Elsevier Limited
• Subjects: Adult; Aged; Clinic; Critical illness; Critical Illness - mortality; Critical Illness - rehabilitation; Female; Health services utilization; Healthcare utilization; Humans; Intensive care; Intensive care unit; Intensive Care Units; Male; Middle Aged; Mobility; Morbidity; Mortality; Muscle Strength; North Carolina; Patient Discharge; Patient Outcome Assessment; Patients; Physical fitness; Physical function; Quality of life; Quantitative analysis; Recovery; Recovery (Medical); Recovery of Function; Surveys and Questionnaires; Survivor; Survivors; North Carolina; United Kingdom > UK; Clinic; Critical illness; Healthcare utilization; Recovery; Physical function; Intensive care unit
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2018.02.001

The aims were to 1) determine feasibility of measuring physical function in our ICU Recovery Clinic (RC), 2) determine if physical function was associated with 6-month re-hospitalization and 1-year mortality and 3) compare ICU survivors' physical function to other comorbid populations.
We established the Wake Forest ICU RC. Patients were seen in clinic 1month following hospital discharge. Testing included the Short Form-36 questionnaire and Short Physical Performance Battery (SPPB). We related these measures to 6month re-hospitalizations and 1year mortality, and compared patients' functional performance with other comorbid populations.
Thirty-six patients were seen in clinic from July 2014 to June 2015; the median SPPB score was 5 (IQR 5). The median SF-36 physical component summary score was 21.8 (IQR 28.8). Mortality was 14% at 1year. Of those who did not die by 1year, 35% were readmitted to our hospital within 6months of hospital discharge. SPPB scores demonstrated a non-significant trend with both mortality (p=0.06) and readmissions (p=0.09). ICU survivors' SPPB scores were significantly lower than those of other chronically ill populations (p<0.001).
Physical function measurement in a recovery clinic is feasible and may inform subsequent morbidity and mortality.
•It is feasible to measure physical function as part of an ICU Recovery Clinic.•Physical function measured by the SPPB may predict readmissions and mortality.•SPPB scores in ICU survivors were significantly lower than other comorbid cohorts.