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Predictors of Activities of Daily Living in Intensive Care Unit Survivors: A Propensity Score Matching Analysis

Matsumoto, Tsuyoshi Yoshikawa, Ryo Harada, Risa Fujii, Yasumitsu Adachi, Akimasa Onishi, Hirokazu Imamura, Ai Takamiya, Daiki Makiura, Daisuke Komaki, Kodai Ogawa, Masato Sakai, Yoshitada 神戸大学

2023

概要

Objectives: Increased long-term impairment is common among intensive care unit (ICU) survivors. However, predictors of activities of daily living (ADL) in ICU survivors are poorly understood. We aimed to focus on the trajectory of physical function and explore the clinical variables that affect ADL at hospital discharge. Methods: We enrolled 411 patients admitted to the ICU from April 2018 to October 2020. Physical function was evaluated at ICU admission, ICU discharge, and hospital discharge. We assessed physical function (grip strength, arm and calf circumference, quadriceps thickness, and Barthel index). Patients were assigned to the high or low ADL group based on their Barthel index at discharge. Propensity score matching analysis was performed to minimize selection biases and differences in clinical characteristics. Results: After matching propensity scores, 114 of the 411 patients (aged 65±15 years) were evaluated. The high ADL group showed better physical function at ICU discharge and hospital discharge than the low ADL group. An overall decreasing trend in muscle mass was observed over time; the rates of decline were lower in the high ADL group than in the low ADL group. The cutoff values for relative changes in calf circumference and quadriceps thickness to predict high ADL were −7.89% (sensitivity: 77.8%, specificity: 55.6%) and −28.1% (sensitivity: 81.0%, specificity: 58.8%), respectively. Conclusions: The relative decreases in calf circumference and quadriceps thickness during hospitalization were lower in patients who maintained their ADL. Assessment of the trajectory of physical function can predict ADL status at hospital discharge among ICU survivors.

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Predictors of Activities of Daily Living in Intensive Care Unit Survivors: A Propensity Score Matching Analysis

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Predictors of Activities of Daily Living in Intensive Care Unit Survivors: A Propensity Score Matching Analysis

概要

この論文で使われている画像

関連論文

Health Literacy Is Associated with Activities of Daily Living of Patients Participating in Cardiac Rehabilitation: A Multicenter Clinical Study

Relationship between health literacy and physical function of patients participating in phase I cardiac rehabilitation: a multicenter clinical study

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Intensive Care Unit Admission for Moderate-to-Severe COVID-19 Patients With Known Cardiovascular Diseases or Their Risk Factors　― Insights From a Nationwide Japanese Cohort Study ―