ICU discharge screening for prediction of new-onset physical disability - a multinational cohort study

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ICU discharge screening for prediction of new-onset physical disability - a multinational cohort study

Milton, Anna (author): Karolinska Institutet

Schandl, Anna (author): Karolinska Institutet

Soliman, Iwo (author): 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.

Joelsson-Alm, Eva (author): Karolinska Institutet

van den Boogaard, Mark (author): Dept. of Intensive Care Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands,Radboud Univ Nijmegen, Med Ctr, Dept Intens Care Med, Nijmegen, Netherlands.

Wallin, Ewa (author): Uppsala universitet,Anestesiologi och intensivvård

Brorsson, Camilla (author): Umeå universitet,Anestesiologi och intensivvård,Umeå Univ, Dept Surg & Perioperat Sci, Umeå, Sweden.

Östberg, Ulrika (author): Dept. of Anaesthesiology and Intensive care, Östersund Hospital, Östersund, Sweden,Östersund Hosp, Dept Anaesthesiol & Intens Care, Östersund, Sweden.

Latocha, Kristine (author): Dept of Intensive Care, Rigshospitalet, Copenhagen, Denmark,Rigshosp Copenhagen, Dept Intens Care, Copenhagen, Denmark.

Savilampi, Johanna, 1977- (author): 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.

Paskins, Stinne (author): Dept of Intensive care, Odense University Hospital, Odense, Denmark,Odense Univ Hosp, Dept Intens Care, Odense, Denmark.

Bottai, Matteo (author): Karolinska Institutet

Sackey, Peter (author): 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
English.
In: Acta Anaesthesiologica Scandinavica. - : Wiley-Blackwell Publishing Inc.. - 0001-5172 .- 1399-6576. ; 64:6, s. 789-797

Related links:: https://doi.org/10.1...; show more...; https://onlinelibrar...; https://umu.diva-por... (primary) (Raw object); https://uu.diva-port... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; https://urn.kb.se/re...; https://urn.kb.se/re...; http://kipublication...; show less...

Journal article (peer-reviewed)

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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.

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By the author/editor: Milton, Anna; Schandl, Anna; Soliman, Iwo; Joelsson-Alm, Ev ...; van den Boogaard ...; Wallin, Ewa; show more...; Brorsson, Camill ...; Östberg, Ulrika; Latocha, Kristin ...; Savilampi, Johan ...; Paskins, Stinne; Bottai, Matteo; Sackey, Peter; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

Articles in the publication: Acta Anaesthesio ...

By the university: Örebro University; Umeå University; Uppsala University; Karolinska Institutet

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ICU discharge screening for prediction of new-onset physical disability - a multinational cohort study

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