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Functional Recovery in Patients With and Without Intensive Care Unit–Acquired Weakness

Dettling-Ihnenfeldt, Daniela Susanne MSc; Wieske, Luuk PhD; Horn, Janneke PhD; Nollet, Frans PhD; van der Schaaf, Marike PhD

American Journal of Physical Medicine & Rehabilitation: April 2017 - Volume 96 - Issue 4 - p 236–242
doi: 10.1097/PHM.0000000000000586
Original Research Articles
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Objective The aim of this work was to compare the patient-reported functional health status with regard to physical, psychological, and social functioning of intensive care unit (ICU) survivors with and without ICU-acquired weakness (ICU-AW).

Design Single-center prospective study in ICU patients who were mechanically ventilated for more than 2 days and who survived to ICU discharge. Functional health status was assessed at 3, 6, and 12 months after ICU discharge, using the Sickness Impact Profile 68 (SIP68). The independent effect of ICU-AW on impaired functional status (SIP68 scores > 20) was analyzed using a multivariable logistic regression model.

Results A total of 133 patients were included, 60 with ICU-AW. Intensive care unit–acquired weakness was an independent predictor for impaired functional health status at 3 months after ICU discharge (odds ratio, 0.27; 95% confidence interval, 0.08–0.94; P = 0.04) but not at 6 and 12 months. Physical functioning was significantly more impaired in patients with ICU-AW at 3 and 12 months. Psychological functioning and social functioning were comparable between the groups, with little restrictions in psychological functioning, and severe long-lasting restrictions in social functioning.

Conclusions The findings of this study urge the need to develop interdisciplinary rehabilitation interventions for ICU survivors, which should be continued after hospital discharge.

From the Departments of Rehabilitation (DSD-I, FN, MvdS), Intensive Care Medicine (LW, JH), and Neurology (LW), Academic Medical Center, University of Amsterdam, the Netherlands; and Amsterdam School of Health Professions, University of Applied Sciences, the Netherlands (MvdS).

All correspondence and requests for reprints should be addressed to: Daniela Susanne Dettling-Ihnenfeldt, MSc, Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Room A01-348, PO Box 22660, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.

This research was performed within the framework of CTMM, the Center of Translational Molecular Medicine (www.ctmm.nl) project MARS (grant 04I-201). Dr. L. Wieske was supported by a personal grant from the Netherlands Organization for Health Research and Development (ZonMw-AGIKO grant 2011 [project number 40-00703-98-11636]). The present material has not been submitted elsewhere and also has not been presented previously.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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