The impact of disability in survivors of critical illness

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To use the World Health Organisation’s International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. Methods: A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been admitted to the ICU, received more than 24 h of mechanical ventilation and survived to hospital discharge. The primary outcome was measurement of disability using the World Health Organisation’s Disability Assessment Schedule 2.0. The secondary outcomes included the limitation of activities and changes to health-related quality of life comparing survivors with and without disability at 6 months after ICU. Results: We followed 262 patients to 6 months, with a mean age of 59 ± 16 years, and of whom 175 (67%) were men. Moderate or severe disability was reported in 65 of 262 (25%). Predictors of disability included a history of anxiety/depression [odds ratio (OR) 1.65 (95% confidence interval (CI) 1.22, 2.23), P = 0.001]; being separated or divorced [OR 2.87 (CI 1.35, 6.08), P = 0.006]; increased duration of mechanical ventilation [OR 1.04 (CI 1.01, 1.08), P = 0.03 per day]; and not being discharged to home from the acute hospital [OR 1.96 (CI 1.01, 3.70) P = 0.04]. Moderate or severe disability at 6 months was associated with limitation in activities, e.g. not returning to work or studies due to health (P < 0.002), and reduced health-related quality of life (P < 0.001). Conclusion: Disability measured using patient-reported outcomes was prevalent at 6 months after critical illness in survivors and was associated with reduced health-related quality of life. Predictors of moderate or severe disability included a prior history of anxiety or depression, separation or divorce and a longer duration of mechanical ventilation. Trial registration: NCT02225938.

Original languageEnglish
Pages (from-to)992-1001
Number of pages10
JournalIntensive Care Medicine
Volume43
Issue number7
DOIs
Publication statusPublished - 1 Jul 2017

Keywords

  • Disability
  • Intensive care
  • Mechanical ventilation
  • Quality of life

Cite this

@article{6316580670c34a06b1824a9e3482bdbc,
title = "The impact of disability in survivors of critical illness",
abstract = "Purpose: To use the World Health Organisation’s International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. Methods: A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been admitted to the ICU, received more than 24 h of mechanical ventilation and survived to hospital discharge. The primary outcome was measurement of disability using the World Health Organisation’s Disability Assessment Schedule 2.0. The secondary outcomes included the limitation of activities and changes to health-related quality of life comparing survivors with and without disability at 6 months after ICU. Results: We followed 262 patients to 6 months, with a mean age of 59 ± 16 years, and of whom 175 (67{\%}) were men. Moderate or severe disability was reported in 65 of 262 (25{\%}). Predictors of disability included a history of anxiety/depression [odds ratio (OR) 1.65 (95{\%} confidence interval (CI) 1.22, 2.23), P = 0.001]; being separated or divorced [OR 2.87 (CI 1.35, 6.08), P = 0.006]; increased duration of mechanical ventilation [OR 1.04 (CI 1.01, 1.08), P = 0.03 per day]; and not being discharged to home from the acute hospital [OR 1.96 (CI 1.01, 3.70) P = 0.04]. Moderate or severe disability at 6 months was associated with limitation in activities, e.g. not returning to work or studies due to health (P < 0.002), and reduced health-related quality of life (P < 0.001). Conclusion: Disability measured using patient-reported outcomes was prevalent at 6 months after critical illness in survivors and was associated with reduced health-related quality of life. Predictors of moderate or severe disability included a prior history of anxiety or depression, separation or divorce and a longer duration of mechanical ventilation. Trial registration: NCT02225938.",
keywords = "Disability, Intensive care, Mechanical ventilation, Quality of life",
author = "Hodgson, {Carol L.} and Udy, {Andrew A.} and Michael Bailey and Jonathan Barrett and Rinaldo Bellomo and Tracey Bucknall and Gabbe, {Belinda J.} and Higgins, {Alisa M.} and Iwashyna, {Theodore J.} and Julian Hunt-Smith and Murray, {Lynne J.} and Myles, {Paul S.} and Jennie Ponsford and David Pilcher and Craig Walker and Meredith Young and D.J. Cooper",
year = "2017",
month = "7",
day = "1",
doi = "10.1007/s00134-017-4830-0",
language = "English",
volume = "43",
pages = "992--1001",
journal = "Intensive Care Medicine",
issn = "0342-4642",
publisher = "Springer-Verlag London Ltd.",
number = "7",

}

The impact of disability in survivors of critical illness. / Hodgson, Carol L.; Udy, Andrew A.; Bailey, Michael; Barrett, Jonathan; Bellomo, Rinaldo; Bucknall, Tracey; Gabbe, Belinda J.; Higgins, Alisa M.; Iwashyna, Theodore J.; Hunt-Smith, Julian; Murray, Lynne J.; Myles, Paul S.; Ponsford, Jennie; Pilcher, David; Walker, Craig; Young, Meredith; Cooper, D.J.

In: Intensive Care Medicine, Vol. 43, No. 7, 01.07.2017, p. 992-1001.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The impact of disability in survivors of critical illness

AU - Hodgson, Carol L.

AU - Udy, Andrew A.

AU - Bailey, Michael

AU - Barrett, Jonathan

AU - Bellomo, Rinaldo

AU - Bucknall, Tracey

AU - Gabbe, Belinda J.

AU - Higgins, Alisa M.

AU - Iwashyna, Theodore J.

AU - Hunt-Smith, Julian

AU - Murray, Lynne J.

AU - Myles, Paul S.

AU - Ponsford, Jennie

AU - Pilcher, David

AU - Walker, Craig

AU - Young, Meredith

AU - Cooper, D.J.

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Purpose: To use the World Health Organisation’s International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. Methods: A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been admitted to the ICU, received more than 24 h of mechanical ventilation and survived to hospital discharge. The primary outcome was measurement of disability using the World Health Organisation’s Disability Assessment Schedule 2.0. The secondary outcomes included the limitation of activities and changes to health-related quality of life comparing survivors with and without disability at 6 months after ICU. Results: We followed 262 patients to 6 months, with a mean age of 59 ± 16 years, and of whom 175 (67%) were men. Moderate or severe disability was reported in 65 of 262 (25%). Predictors of disability included a history of anxiety/depression [odds ratio (OR) 1.65 (95% confidence interval (CI) 1.22, 2.23), P = 0.001]; being separated or divorced [OR 2.87 (CI 1.35, 6.08), P = 0.006]; increased duration of mechanical ventilation [OR 1.04 (CI 1.01, 1.08), P = 0.03 per day]; and not being discharged to home from the acute hospital [OR 1.96 (CI 1.01, 3.70) P = 0.04]. Moderate or severe disability at 6 months was associated with limitation in activities, e.g. not returning to work or studies due to health (P < 0.002), and reduced health-related quality of life (P < 0.001). Conclusion: Disability measured using patient-reported outcomes was prevalent at 6 months after critical illness in survivors and was associated with reduced health-related quality of life. Predictors of moderate or severe disability included a prior history of anxiety or depression, separation or divorce and a longer duration of mechanical ventilation. Trial registration: NCT02225938.

AB - Purpose: To use the World Health Organisation’s International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. Methods: A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been admitted to the ICU, received more than 24 h of mechanical ventilation and survived to hospital discharge. The primary outcome was measurement of disability using the World Health Organisation’s Disability Assessment Schedule 2.0. The secondary outcomes included the limitation of activities and changes to health-related quality of life comparing survivors with and without disability at 6 months after ICU. Results: We followed 262 patients to 6 months, with a mean age of 59 ± 16 years, and of whom 175 (67%) were men. Moderate or severe disability was reported in 65 of 262 (25%). Predictors of disability included a history of anxiety/depression [odds ratio (OR) 1.65 (95% confidence interval (CI) 1.22, 2.23), P = 0.001]; being separated or divorced [OR 2.87 (CI 1.35, 6.08), P = 0.006]; increased duration of mechanical ventilation [OR 1.04 (CI 1.01, 1.08), P = 0.03 per day]; and not being discharged to home from the acute hospital [OR 1.96 (CI 1.01, 3.70) P = 0.04]. Moderate or severe disability at 6 months was associated with limitation in activities, e.g. not returning to work or studies due to health (P < 0.002), and reduced health-related quality of life (P < 0.001). Conclusion: Disability measured using patient-reported outcomes was prevalent at 6 months after critical illness in survivors and was associated with reduced health-related quality of life. Predictors of moderate or severe disability included a prior history of anxiety or depression, separation or divorce and a longer duration of mechanical ventilation. Trial registration: NCT02225938.

KW - Disability

KW - Intensive care

KW - Mechanical ventilation

KW - Quality of life

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U2 - 10.1007/s00134-017-4830-0

DO - 10.1007/s00134-017-4830-0

M3 - Article

VL - 43

SP - 992

EP - 1001

JO - Intensive Care Medicine

JF - Intensive Care Medicine

SN - 0342-4642

IS - 7

ER -