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Published on: May 10, 2019
Race and Ethnicity Are Associated With Physical Impairment Among ICU Survivors
Megan A Watson1, Mikita Fuchita2, Ellen L Burnham1
1Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Colorado, Aurora, CO.
Objectives:
To evaluate whether race and ethnicity are associated with increased odds of physical impairment among post-ICU survivors and to assess how impairment influences healthcare utilization after hospital discharge.
Design:
This was a retrospective cohort study.
Setting:
The study was conducted at an academic medical center.
Patients:
We included 4370 adult ICU survivors who experienced shock, respiratory failure, or received extracorporeal membrane oxygenation.
Interventions:
None.
Measurements And Main Results:
The primary exposure was self-reported race and ethnicity. The primary outcome was impairment at hospital discharge, defined using the International Classification of Diseases, 10th Revision codes and/or a Johns Hopkins Highest Level of Mobility score of less than or equal to 5. Multivariable logistic regression was used to assess associations with impairment, and Fine-Gray models evaluated post-discharge healthcare utilization. Impairment was identified in 31% of ICU survivors. Non-Hispanic Black race was associated with increased odds of any impairment (adjusted odds ratio [aOR], 1.34; 95% CI, 1.04-1.72), and Hispanic ethnicity was associated with increased odds of new impairment (aOR, 1.42; 95% CI, 1.05-1.91), compared with non-Hispanic White-identifying survivors. Among those with impairment, both non-Hispanic Black and Hispanic individuals had increased risk of healthcare utilization within 1 year.
Conclusions:
Non-Hispanic Black race and Hispanic ethnicity are associated with increased odds of post-ICU physical impairment and subsequent healthcare utilization. These findings highlight the need to understand root causes better and explore targeted interventions to reduce disparities among ICU survivors.
