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ICU discharge scree...
ICU discharge screening for prediction of new-onset physical disability - a multinational cohort study
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- Milton, Anna (författare)
- Karolinska Institutet
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- Schandl, Anna (författare)
- Karolinska Institutet
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- Soliman, Iwo (författare)
- Dept. of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands,Univ Utrecht, Univ Med Ctr Utrecht, Dept Intens Care Med, Utrecht, Netherlands.
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- Joelsson-Alm, Eva (författare)
- Karolinska Institutet
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- van den Boogaard, Mark (författare)
- Dept. of Intensive Care Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands,Radboud Univ Nijmegen, Med Ctr, Dept Intens Care Med, Nijmegen, Netherlands.
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- Wallin, Ewa (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- Brorsson, Camilla (författare)
- Umeå universitet,Anestesiologi och intensivvård,Umeå Univ, Dept Surg & Perioperat Sci, Umeå, Sweden.
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- Östberg, Ulrika (författare)
- Dept. of Anaesthesiology and Intensive care, Östersund Hospital, Östersund, Sweden,Östersund Hosp, Dept Anaesthesiol & Intens Care, Östersund, Sweden.
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- Latocha, Kristine (författare)
- Dept of Intensive Care, Rigshospitalet, Copenhagen, Denmark,Rigshosp Copenhagen, Dept Intens Care, Copenhagen, Denmark.
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- Savilampi, Johanna, 1977- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Dept. of Anaesthesiology and Intensive care,Örebro Univ, Sch Med Sci, Örebro, Sweden.;Örebro Univ Hosp, Dept Anaesthesiol & Intens Care, Örebro, Sweden.
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- Paskins, Stinne (författare)
- Dept of Intensive care, Odense University Hospital, Odense, Denmark,Odense Univ Hosp, Dept Intens Care, Odense, Denmark.
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- Bottai, Matteo (författare)
- Karolinska Institutet
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- Sackey, Peter (författare)
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Dept Physiol & Pharmacol, Solna, Sweden.
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Karolinska Institutet Dept of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands (creator_code:org_t)
- 2020-02-28
- 2020
- Engelska.
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley-Blackwell Publishing Inc.. - 0001-5172 .- 1399-6576. ; 64:6, s. 789-797
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Methods to identify patients at risk for incomplete physical recovery after intensive care unit (ICU) stay are lacking. Our aim was to develop a method for prediction of new-onset physical disability at ICU discharge.METHODS: Multinational prospective cohort study in ten general ICUs in Sweden, Denmark and the Netherlands. Adult patients with an ICU stay ≥12 hours were eligible for inclusion. Sixteen candidate predictors were analyzed with logistic regression for associations with the primary outcome; new-onset physical disability three months post-ICU, defined as a ≥10 score reduction in the Barthel Index compared to baseline.RESULTS: Of 572 included patients, follow-up data are available on 78% of patients alive at follow-up. The incidence of new-onset physical disability was 19%. Univariable and multivariable modeling rendered one sole predictor for the outcome: physical status at ICU discharge, assessed with the five first items of the Chelsea Critical Care Physical Assessment Tool (CPAx) (odds ratio 0.87, 95% confidence interval (CI) 0.81 to 0.93), a higher score indicating a lower risk, with an area under the receiver operating characteristics curve of 0.68 (95% CI 0.61 to 0.76). Negative predictive value for a low-risk group (CPAx score >18) was 0.88, positive predictive value for a high-risk group (CPAx score ≤18) was 0.32.CONCLUSION: The ICU discharge assessment described in this study had a moderate AUC but may be useful to rule out patients unlikely to need physical interventions post-ICU. For high-risk patients, research to determine post-ICU risk factors for an incomplete rehabilitation is mandated.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Activities of daily living
- complications
- critical care
- decision support techniques
- intensive care unit
- rehabilitation
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- ref (ämneskategori)
- art (ämneskategori)
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Milton, Anna
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Schandl, Anna
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Soliman, Iwo
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Joelsson-Alm, Ev ...
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van den Boogaard ...
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Wallin, Ewa
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visa fler...
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Brorsson, Camill ...
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Östberg, Ulrika
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Latocha, Kristin ...
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Savilampi, Johan ...
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Paskins, Stinne
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Bottai, Matteo
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Sackey, Peter
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Örebro universitet
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Umeå universitet
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Uppsala universitet
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Karolinska Institutet