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Risk Factors for Functional Decline and Relationship With Quality of Life.

Camila Dietrich1, Caroline Cabral Robinson2, Daniel Sganzerla3

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Summary

Functional decline is common after intensive care unit (ICU) stays, affecting over half of survivors. Risk factors include older age, lower education, and critical illness severity, significantly impacting quality of life.

Keywords:
critical carecritical care outcomesfunctional statusquality of liferehabilitation

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Area of Science:

  • Critical care medicine
  • Rehabilitation medicine
  • Public health

Background:

  • Intensive care unit (ICU) admission and treatments can lead to functional decline and reduced quality of life post-discharge.
  • Identifying risk factors for functional decline is crucial for improving long-term outcomes in critically ill patients.

Purpose of the Study:

  • To identify risk factors associated with functional decline after critical illness.
  • To explore the impact of functional decline on health-related quality of life in ICU survivors.

Main Methods:

  • A post hoc analysis of a prospective, multi-center cohort study involving 1,301 critically ill patients in Brazil.
  • Assessment of functional status (Barthel score) and quality of life (Short-Form Health Survey) 3 months post-ICU discharge.
  • Analysis included 954 patients with pre-ICU baseline functional data.

Main Results:

  • Functional decline was observed in 58.9% (562/954) of ICU survivors.
  • Risk factors for decline included older age (≥65 years), lower educational level, high ICU mortality risk, and ICU-acquired weakness, anxiety, or depression.
  • Functional decline correlated with significantly lower physical and mental health-related quality of life scores.

Conclusions:

  • Functional decline is a prevalent outcome following ICU stays, influenced by pre-ICU patient characteristics and critical illness severity.
  • The identified risk factors highlight vulnerable patient groups needing targeted interventions.
  • Functional decline substantially diminishes the health-related quality of life for ICU survivors.