>Year 2016, Issue 2
Rodríguez ISA, Núñez BRG, Zaragoza GJJ, Martínez ZR, Cerón DUW
Basal functional status at admission to intensive care unit and relationship with hospital mortality
Rev Asoc Mex Med Crit y Ter Int 2016; 30 (2)
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Introduction: We investigated the basal functional status prior to admission of patients to the Intensive Care Unit and its association with mortality during their stay in the Intensive Care Unit and hospital mortality, and its relationship with 3 scores (SOFA, MMP-3 and SAPS III).
Material and methods: Retrospective and descriptive study of patients registered prospectively in the database of the Intensive Care Unit during the period from 2009 to 2015. Basal functional status was evaluated according to a scale based and modified about ECOG. We conduct a univariate analysis dividing living and dead later compare groups according to their basal functional status through an analysis of variance to finally conduct a multiple logistic regression analysis to identify variables independently associated with higher hospital mortality.
Results: 2,028 patients were included. Univariate analysis showed that the degree of deterioration of the basal functional status before admission is associated with hospital mortality and the mortality scores (p ≤ 0.05) in the comparison between living and dead as in the comparison between degrees of impairment functional state, a further deterioration increased mortality. The multiple logistic regression analysis did not identify the basal functional status as a variable independently associated with mortality; the following variables: age, cardiac arrest provides no overall SOFA, neurological SOFA, SAPS III and MMP-3 are independently associated with increased hospital mortality; while the place of origin, the days of Intensive Care Unit and hospital stay were associated with lower hospital mortality.
Conclusion: The basal functional status not independently associated with hospital mortality unlike scores of mortality, suggesting that it is not the basal functional status which is associated with mortality but rather the severity of the patient upon admission and during hospitalization.
||Basal functional status, performance status, mortality, Intensive Care Unit, critically ill patients, ECOG, multiple organ failure.
Zubrod CG, Scheneidermann M, Frei E, et al. Appraisal of methods for the study of chemotherapy of cancer in man: comparative therapeutic trial of nitrogen mustard and trietyhylene thiophosphoramide. J Chron Dis. 1960;11:7-33.
Yates JW, Chalmer B, McKegney FP. Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer. 1980;45:2220-2224.
Mor V, Laliberte L, Morris JN, et al. The Karnofsky performance status scale: an examination of its reliability and validity in a research setting. Cancer. 1984;53:2002-2007.
Rosenthal MA, Gebski VJ, Kefford RF, Stuart-Harris RC. Prediction of life expectancy in hospice patients: identification of novel prognostic factors. Palliat Med. 1993;7:199-204.
Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the eastern cooperative oncology group. Am J Clin Oncol. 1982;5:649-655.
Cid-Ruzafa J, Damián-Moreno J. Valoración de la discapacidad física: el índice de Barthel. Rev Esp Salud Publica. 1997;71(2):127-137.
van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988;19(5):604-607.
Katz S, Ford AB, Moskowitz RW, et al. Studies of illness in the age: the index of ADL a standarized measure of biological and psycosocial function. JAMA. 1963;185:914-919.
Graf J, Koch M, Dujardin R, Kersten A, Janssens U. Health-related quality of life before, 1 month after, and 9 months after intensive care in medical cardiovascular and pulmonary patients. Crit Care Med. 2003;31(8):2163-2169.
Angus DC, Carlet J. Surviving intensive care: a report from the 2002 Brussels roundtable. Intensive Care Med. 2003;29(3):368-377.
Hortigüela-Martín VA, Sanchez-Casado M, Rodríguez-Villar S, Quintana-Díaz M, Marco-Schulke C, Gómez-Tello V, et al. Post-Intensive Care Unit mortality and related prognostic factors in a cohort of critically ill patients with multi-organ dysfunction. Med Clin (Barc). 2013;140(11):479-486.
García-Lizana F, Manzano-Alonso JL, González-Santana B, Fuentes-Esteban J, Saavedra-Santana P. Survival and quality of life of patients with multiple organ failure one year after leaving an intensive care unit. Med Clin (Barc). 2000;114(Suppl 3):99-103.
Eddleston JM, White P, Guthrie E. Survival, morbidity, and quality of life after discharge from intensive care. Crit Care Med. 2000;28(7):2293-2299.
Black NA, Jenkinson C, Hayes JA, Young D, Vella K, Rowan KM, et al. Review of outcome measures used in adult critical care. Crit Care Med. 2001;29(11):2119-2124.
Dinglas VD, Gellar J, Colantuoni E, Stan VA, Mendez-tellez PA, Pronovost PJ, et al. Does ICU severity of illness influence recall of baseline physical function? J Crit Care. 2011;26(6):634.e1-7.
Schenk P, Warszawska J, Fuhrmann V, König F, Madl C, Ratheiser K. Health-related quality of life of long-term survivors of intensive care: changes after intensive care treatment: experience of an Austrian intensive care unit. Wien Klin Wochenschr. 2012;124(17-18):624-632.
Cuthbertson BH, Scott J, Strachan M, Kilonzo M, Vale L. Quality of life before and after intensive care. Anaesthesia. 2005;60(4):332-339.
Jacobs CJ, van der Vliet JA, van Roozendaal MT, van der Linden CJ. Mortality and quality of life after intensive care for critical illness. Intensive Care Med. 1988;14(3):217-220.
Iwashyna TJ, Ely EW, Smith DM, Langa KM. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010;304(16):1787-1794.
Chatila W, Kreimer DT, Criner GJ. Quality of life in survivors of prolonged mechanical ventilatory support. Crit Care Med. 2001;29(4):737-742.
Granja C, Morujao E, Costa-Pereira A. Quality of life in acute respiratory distress syndrome survivors may be no worse than in other ICU survivors. Intensive Care Med. 2003;29(10):1744-1750.
Dowdy DW, Eid MP, Sedrakyan A, Mendez-Tellez PA, Pronovost PJ, Herridge MS, et al. Quality of life in adult survivors of critical illness: a systematic review of the literature. Intensive Care Med. 2005;31(5):611-620.
Rodríguez-Villar S, Fernández-Méndez R, Adams G, Rodríguez-García JL, Arévalo-Serrano J, Sánchez-Casado M, et al. Basal functional status predicts functional recovery in critically ill patients with multiple-organ failure. J Crit Care. 2015;30(3):511-517.
van der Schaaf M, Dettling DS, Beelen A, Lucas C, Dongelmans DA, Nollet F. Poor functional status immediately after discharge from an intensive care unit. Disabil Rehabil. 2008;30(23):1812-1818.
Conlon N, O’Brien B, Herbison GP, Marsh B. Long-term functional outcome and performance status after intensive care unit re-admission: a prospective survey. Br J Anaesth. 2008;100(2):219-223.
Montuclard L, Garrouste-Orgeas M, Timsit JF, Misset B, De Jonghe B, Carlet J. Outcome, functional autonomy, and quality of life of elderly patients with a long-term intensive care unit stay. Crit Care Med. 2000;28(10):3389-3395.
>Year 2016, Issue 2