Physical impairment and perceived general health preceding critical illness is predictive of survival

We hypothesized that item response based assessment of physical reserve preceding ICU admission is a predictor of survival. We evaluated physical functioning using the Academic Medical Center Linear Disability Score (ALDS) and quality of life using the first question (SF-1) and the physical componen...

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Veröffentlicht in:Journal of critical care 2019-06, Vol.51, p.51-56
Hauptverfasser: Hofhuis, José G.M., Abu-Hanna, Ameen, de Zwart, Lisa, Hovingh, Aly, Spronk, Peter E.
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container_end_page 56
container_issue
container_start_page 51
container_title Journal of critical care
container_volume 51
creator Hofhuis, José G.M.
Abu-Hanna, Ameen
de Zwart, Lisa
Hovingh, Aly
Spronk, Peter E.
description We hypothesized that item response based assessment of physical reserve preceding ICU admission is a predictor of survival. We evaluated physical functioning using the Academic Medical Center Linear Disability Score (ALDS) and quality of life using the first question (SF-1) and the physical component score (PCS-12) from the Short-form 12 (SF-12) before admission by patients or by close proxies within 72 h after ICU admission during 1 year. We developed four logistic regression models to predict 1 year mortality using the predictors age, gender, ALDS, SF-1, PCS-12. A total of 510 patients participated. Twelve months after ICU discharge, 110 patients (22%) had died. Pre-admission ALDS (p = .004), and SF-1 (p = .012) improved the prediction models with age and gender PCS-12 showed no association with mortality (p = .062). Adding the ALDS (p = .049) and the SF-1 (p = .048) to a model with age, gender and the APACHE II score (improved the model. Adding PCS-12 showed no association with mortality (p = .355). Physical reserve as assessed by ALDS and perceived general health, preceding ICU admission is predictive of mortality. Obtaining patient's physical reserve or pre-existing perceived general health should be part of routine assessment whether a patient may benefit from ICU admission. •Next to age and gender, pre-ICU admission general health status is important to predict mortality.•Adding APACHE II score after ICU admission had occurred improved the model's predictive property.•ALDS and SF-1 nomograms may help to estimate the mortality risk for individual patients in practice.
doi_str_mv 10.1016/j.jcrc.2019.01.027
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We evaluated physical functioning using the Academic Medical Center Linear Disability Score (ALDS) and quality of life using the first question (SF-1) and the physical component score (PCS-12) from the Short-form 12 (SF-12) before admission by patients or by close proxies within 72 h after ICU admission during 1 year. We developed four logistic regression models to predict 1 year mortality using the predictors age, gender, ALDS, SF-1, PCS-12. A total of 510 patients participated. Twelve months after ICU discharge, 110 patients (22%) had died. Pre-admission ALDS (p = .004), and SF-1 (p = .012) improved the prediction models with age and gender PCS-12 showed no association with mortality (p = .062). Adding the ALDS (p = .049) and the SF-1 (p = .048) to a model with age, gender and the APACHE II score (improved the model. Adding PCS-12 showed no association with mortality (p = .355). Physical reserve as assessed by ALDS and perceived general health, preceding ICU admission is predictive of mortality. Obtaining patient's physical reserve or pre-existing perceived general health should be part of routine assessment whether a patient may benefit from ICU admission. •Next to age and gender, pre-ICU admission general health status is important to predict mortality.•Adding APACHE II score after ICU admission had occurred improved the model's predictive property.•ALDS and SF-1 nomograms may help to estimate the mortality risk for individual patients in practice.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2019.01.027</identifier><identifier>PMID: 30745286</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Clinical outcomes ; Critical care ; Critical illness ; Gender ; Hospitals ; Mortality ; Nomogram ; Outcome ; Pathology ; Patients ; Physical fitness ; Physical reserve ; Quality of life</subject><ispartof>Journal of critical care, 2019-06, Vol.51, p.51-56</ispartof><rights>2019</rights><rights>Copyright © 2019. 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source ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland
subjects Age
Clinical outcomes
Critical care
Critical illness
Gender
Hospitals
Mortality
Nomogram
Outcome
Pathology
Patients
Physical fitness
Physical reserve
Quality of life
title Physical impairment and perceived general health preceding critical illness is predictive of survival
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