Association between changes in disease severity and physical function after surviving a critical illness: A...

Area of Science:

• Critical Care Medicine
• Neurology
• Rehabilitation Medicine

Background:

• Disease severity significantly impacts patient functional outcomes.
• Predicting the extent of functional impairment has been inconsistent.
• Early assessment of critical illness severity is crucial for patient management.

Purpose of the Study:

• To determine if changes in disease severity within 48 hours of ICU admission predict physical dysfunction better than a single assessment.
• To investigate the association between early changes in Sequential Organ Failure Assessment (SOFA) scores and physical function at hospital discharge.

Main Methods:

• A multicentre retrospective study of 199 adult ICU patients in Japan.
• Assessed physical function using the Barthel Index at hospital discharge.
• Analyzed the association between Barthel Index and SOFA scores at ICU admission, peak SOFA within 48 hours, and the change between these scores.

Main Results:

• The highest SOFA score within 48 hours and the change in SOFA scores were significantly associated with lower Barthel Index scores at discharge.
• A SOFA score increase of 1 or more within 48 hours predicted a Barthel Index score of 60 or less.
• No significant association was found between SOFA score at ICU admission and Barthel Index scores.

Conclusions:

• Changes in SOFA score within the first 48 hours of ICU stay are more predictive of physical dysfunction at discharge than a single admission assessment.
• Worsening SOFA scores in early ICU stay may indicate reduced recovery potential after critical illness.