Responsiveness of Critically Ill Adults With Multimorbidity to Rehabilitation Interventions: A Patient-Level...

Area of Science:

• Critical care medicine
• Rehabilitation science
• Health services research

Background:

• Physical rehabilitation is crucial for post-critical care recovery.
• Patient characteristics may influence rehabilitation effectiveness.
• Identifying subgroups that benefit most can optimize interventions.

Approach:

• Pooled individual patient data from four randomized controlled trials (RCTs) of critical care physical rehabilitation.
• Analyzed data from 810 patients using linear mixed models.
• Investigated the impact of comorbidities, age, sex, and illness severity on health-related quality of life (HRQoL) and physical performance.

Key Points:

• Patients with two or more comorbidities showed significantly improved HRQoL (Physical Component Summary score) at 3 and 6 months post-intervention compared to controls.
• No HRQoL benefits were observed at 3 or 6 months for patients with one or no comorbidities.
• No patient characteristics modified the effects of rehabilitation on objective physical performance outcomes.

Conclusions:

• Patients with multiple comorbidities represent a target population for physical rehabilitation interventions in the post-critical care setting.
• Findings suggest tailored rehabilitation strategies may be beneficial for specific patient subgroups.
• Further prospective studies are warranted to confirm these benefits in the multimorbid post-ICU population.