Functional status after intensive care: a challenge for rehabilitation professionals to improve outcome.

The objectives of this study were to determine the restrictions in daily functioning from a rehabilitation perspective in patients one year after discharge from the intensive care unit, and to identify prognostic factors for functional status.  The study sample included  255 consecutive patients admitted to intensive care for more than 48 hours. A year after intensive care, functional status (the primary outcome), and Quality of Life, anxiety and depression, and post-traumatic stress disorder were evaluated using relevant scales. The results showed that fifty-four percent of the patients had restrictions in daily functioning. Walking and social activities were most frequently restricted (30-60% of the patients). Quality of life was lower than the general Dutch population. Symptoms of anxiety and depression were found in 14%, and post-traumatic stress disorder in 18%. Severity of illness at admission and length of stay in the intensive care unit were identified as prognostic factors, although they explained only 10% of functional status.

The high rate of long-lasting restrictions in physical, social and psychological functioning among patients who stayed in the intensive care unit for at least 2 days implies that these patients are a potential target population for rehabilitation medicine. Multidisciplinary therapies need to be developed and evaluated in order to improve outcome.

van der Scaaf M, Beelen A, Dongelmans DA, Vroom MB, Nollet F. Functional status after intensive care: a challenge for rehabilitation professionals to improve outcome. Journal of Rehabilitation Medicine 2009; 41 (5) :360-6