Background
Methods
Design
Study population
Assessment of PFS
Data collection
Data classification
Ethics
Statistical analysis
Results
Study population
ICU admission data | Planned surgical admission (n = 199) | Medical and unplanned surgical admission (n = 300) |
p
|
---|---|---|---|
Age, years | 58.5 ± 18.5 | 62.4 ± 17.0 |
0.01
|
Male gender | 108 (54.3) | 149 (49.7) |
ns
|
Number of pre-existing disorders | |||
≤ 2 | 176 (88.5) | 244 (81.3) |
ns
|
> 2 | 23 (11.5) | 56 (18.7) |
ns
|
BMI
a
| |||
< 25 Kg/m2
| 81 (40.7) | 121 (40.3) |
ns
|
≥ 25 Kg/m2
| 118 (59.3) | 179 (59.7) |
ns
|
Reason for ICU-admission |
ns
| ||
Planned surgery | 199 | -- | |
Heart | -- | 113 (37.7) | |
Neurological | -- | 59 (19.7) | |
Respiratory | -- | 60 (20.0) | |
Trauma | -- | 18 (6.0) | |
Other | -- | 50 (16.6) | |
Days on MV |
<0.001
| ||
Did not receive MV | 121 (60.8) | 222 (74.0) | |
1 day | 18 (9.1) | 59 (19.7) | |
2 to 7 days | 31 (15.6) | 10 (3.3) | |
≥ 8 days | 29 (14.5) | 9 (3.0) | |
ICU stay (days) | 5 [3:8] | 6 [3:11] | |
Severity scores | |||
APACHE II at 1st ICU day | 10.2 ± 5.4 | 14.2 ± 8.2 |
<0.001
|
SOFA at 1st ICU day | 0 | [0:1] |
ns
|
TISS at 1st ICU day | 18 ± 6.5 | 17.6 ± 6.8 |
0.06
|
TISS at 3rd ICU day | 20.4 ± 6.4 | 17.4 ± 6.8 |
0.02
|
TISS discharge | 11.5 ± 3.7 | 10.5 ± 4.7 |
0.01
|
Evaluation of functional status at ICU admission | |||
Karnofsky scale (K-ICU) | 87.8 ± 10.5 | 86.6 ± 13.8 |
ns
|
Lawton scale (L-ICU) | 28.8 ± 6.9 | 27.3 ± 8.6 |
ns
|
Evaluation of functional status after 24 mo | |||
Karnofsky scale (K-24mo) | 86.0 ± 13.6 | 77.1 ± 19.6 |
<0.001
|
Lawton scale (L-24mo) | 27.0 ± 11.7 | 22.5 ± 11.5 |
<0.001
|
Determinants of physical functional status 24 months after ICU discharge2
Variables | n | Functional impairment (%) |
p
| |||
---|---|---|---|---|---|---|
Severe | Moderate | No change | Improvement | |||
Age (Karnofsky), years |
<0.001
| |||||
< 65 |
265
| 7 | 26 | 53 | 14
a
| |
≥ 65 |
234
| 13
a
| 24 | 61 | 2 | |
Age (Lawton) |
<0.001
| |||||
< 65 |
265
|
12
| 14 | 66a
| 8a
| |
≥ 65 |
234
|
20
a
| 23a
| 57 | 0 | |
Stay in ICU (Karnofsky) |
<0.001
| |||||
< 7 days |
401
| 7 | 24 | 59
a
| 10
a
| |
8-14 days |
52
| 23
a
| 29 | 48 | 0 | |
≥ 15 days |
46
| 23
a
| 30 | 42 | 5 | |
Stay in ICU (Lawton) | ||||||
< 7 days |
401
| 13 | 17 | 65a
| 5 | |
8-14 days |
52
| 21 | 25 | 54 | 0 | |
≥ 15 days |
46
| 35a
| 16 | 40 | 9 | |
BMI
a
(Karnofsky) |
<0.001
| |||||
< 25 Kg/m2
|
202
| 11 | 26 | 58 | 5 | |
≥ 25 Kg/m2
|
297
| 4 | 21 | 51 | 24
a
| |
BMI
a
(Lawton) |
<0.001
| |||||
< 30 Kg/m2
|
202
| 17 | 18 | 63 | 2 | |
≥ 30 Kg/m2
|
297
| 10 | 18 | 55 | 17a
| |
Reason for ICU admission (Karnofsky) |
<0.001
| |||||
Heart |
113
| 5 | 22 | 69
a
| 4 | |
Neurological |
59
| 39
a
| 34 | 27 | 0 | |
Respiratory |
60
| 8 | 23 | 69
a
| 0 | |
Trauma |
18
| 22 | 45
a
| 33 | 0 | |
Planned surgery |
199
| 3 | 21 | 57 | 19
a
| |
Other |
50
| 12 | 30 | 54 | 4 | |
Reason for ICU admission (Lawton) |
<0.001
| |||||
Heart |
113
| 11 | 13 | 73a
| 3 | |
Neurological |
59
| 51a
| 30a
| 17 | 2 | |
Respiratory |
60
| 8 | 20 | 70 | 2 | |
Trauma |
18
| 33 | 17 | 50 | 0 | |
Planned surgery |
199
| 8 | 18 | 66 | 8a
| |
Other |
50
| 20 | 14 | 62 | 4 | |
Days on MV (Karnofsky) |
<0.001
| |||||
Did not use MV |
352
| 9 | 27
a
| 55 | 9 | |
1 day |
78
| 5 | 17 | 67 | 11 | |
2 to 7 days |
37
| 13 | 16 | 68 | 3 | |
≥ 8 days |
32
| 31
a
| 25 | 44 | 0 | |
Days on MV (Lawton) |
0.021
| |||||
Did not use MV |
352
|
15
| 19 | 61 | 5 | |
1 day |
78
|
10
| 12 | 73a
| 5 | |
2 to 7 days |
37
|
19
| 13 | 65 | 3 | |
≥ 8 days |
32
|
33
a
| 26 | 38 | 3 | |
APACHE II at 1st ICU day |
499
| 14 ± 6§
| 12 ± 6.5§*
| 13 ± 8§
| 8 ± 5*
|
0.02
*
|
SOFA at 1st ICU day |
499
| (0 0:2)§
| (0 0:1)§*
| (0 0:0)*
| (0 0:0)*
|
0.003
b
|
Subjective impression (Karnofsky) |
<0.001
| |||||
Equal |
172
| 1 | 17 | 78
a
| 4 | |
Worse |
156
| 30
a
| 53
a
| 17 | 0 | |
Better |
171
| 0 | 7 | 72
a
| 21
a
| |
Subjective impression (Lawton) |
<0.001
| |||||
Equal |
172
| 4 | 14 | 82a
| 0 | |
Worse |
156
| 46a
| 30a
| 24 | 0 | |
Better |
171
| 1 | 11 | 75a
| 12a
|
Characteristic | RR | 95% CI |
p
|
---|---|---|---|
Reason for ICU admission | |||
Medical and unplanned surgery (Karnofsky) | 1.3 | 1.1 – 1.5 | 0.04 |
Medical and unplanned surgery (Lawton-ADL) | 1.3 | 1.01 – 1.65 | 0.03 |
Neurological (Karnofsky) | 2.6 | 1.8 – 3.6 | < 0.001 |
Neurological (Lawton-ADL) | 3.3 | 2.3 – 4.6 | < 0.001 |
Trauma (Karnofsky) | 2.7 | 1.6 – 4.6 | < 0.001 |
Trauma (Lawton-ADL) | 2.8 | 1.5 – 5.1 | 0.001 |
Age ≥ 65 years (Lawton-ADL) | 1.4 | 1.07 – 1.86 | 0.01 |
MV ≥ 8 days (Lawton-ADL) | 1.48 | 1.02 – 2.15 | 0.03 |