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Published on: January 16, 2019
Physical recovery in intensive care unit survivors: a cohort analysis
Leanne M Aitken1, Elizabeth Burmeister2, Sharon McKinley2
1Leanne M. Aitken is a professor of critical care nursing, Centre for Health Practice Innovation, Griffith Health Institute and School of Nursing and Midwifery, Griffith University, Brisbane, Australia, and Princess Alexandra Hospital, Brisbane, Australia. Elizabeth Burmeister is a nurse researcher, Nursing Practice Development Unit, Princess Alexandra Hospital and Centre for Health Practice Innovation, Griffith University. Sharon McKinley is a professor of critical care nursing, Faculty of Nursing Midwifery and Health, University of Technology, Sydney, and Northern Sydney Local Health District, Sydney, Australia. Jennifer Alison is a professor of respiratory physiotherapy, Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, and Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney, Australia. Madeleine King holds the Cancer Australia Chair in Cancer Quality of Life, School of Psychology, University of Sydney. Gavin Leslie is a professor of nursing, School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, Australia. Doug Elliott is a professor of nursing, Faculty of Health, University of Technology, Sydney, Australia. l.aitken@griffith.edu.au.
Background:
Some survivors of critical illness experience poor physical recovery, but which patients experience the most compromise during recovery is unknown.
Objective:
To identify factors associated with physical recovery by using the 6-minute walk test in adult survivors of critical illness 26 weeks after discharge from the hospital.
Methods:
A total of 195 adult survivors of a critical illness were enrolled in a multicenter trial of physical rehabilitation after discharge from the hospital. The 6-minute walk test, the 36-Item Short Form Health Survey, and sleep rated on a 5-point scale were completed at weeks 1 and 26. Clinical and demographic data were obtained from patient records.
Results:
A total of 145 patients completed the 26-week test. Of these, 94 (65%) increased the distance walked in 6 minutes by at least 75 m from the 1-week value and were therefore considered to have improved on the test. Factors associated with improvement included moderate to severe sleeping problems in week 1, moderate to vigorous exercise in week 26, and higher vitality in week 26. Conversely, respiratory problems and higher social functioning in week 1 were associated with less improvement in the distance walked.
Conclusion:
Multiple factors are associated with physical recovery after critical illness. Interventions to target multidimensional aspects of recovery such as sleep and exercise may result in improved physical function after critical illness.
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