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Long-term functional outcome after intensive care

V M Roche1, A Kramer, E Hester

  • 1Department of Medicine, Denver Veterans Administration Medical Center and University of Colorado Health Sciences Center, Center on Aging, 80220, USA.

Journal of the American Geriatrics Society
|January 27, 1999
PubMed
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Older adults admitted to the intensive care unit (ICU) had similar functional recovery rates and speed as younger patients. Baseline function, not illness severity, was key for recovery, while severity predicted mortality.

Area of Science:

  • Critical Care Medicine
  • Geriatric Medicine
  • Rehabilitation Medicine

Background:

  • Age-related mortality post-intensive care unit (ICU) admission is documented, but functional recovery across age groups remains less understood.
  • Older adults may experience different functional trajectories after critical illness compared to younger populations.

Purpose of the Study:

  • To investigate and compare functional recovery patterns in older (≥65 years) versus younger patients following ICU admission.
  • To identify predictors of functional recovery and mortality in diverse age groups post-ICU.

Main Methods:

  • A prospective observational cohort study was conducted with 222 patients admitted to a medical or surgical ICU.
  • Data collected included demographics, baseline functional status, Acute Physiology and Chronic Health Evaluation (APACHE II) scores, and functional status at 6 weeks and 6 months post-ICU.

Related Experiment Videos

  • Multiple regression analysis was used to adjust for baseline function, age, APACHE II, and Acute Physiology Score (APS).

    • Main Results:

    • Fifty-two percent of all patients returned to their baseline function by 6 months post-ICU.
    • While older patients had worse baseline function, their recovery proportion and rate at 6 weeks and 6 months were comparable to younger patients.
    • Baseline functional status was a significant predictor of recovery at both 6 weeks and 6 months (P < .001 and P = .002, respectively).
    • Age significantly predicted recovery at 6 months (P = .04), but not at 6 weeks (P = .26).
    • APACHE II scores predicted mortality (P < .001) but not functional recovery.

    Conclusions:

    • Older individuals admitted to the ICU demonstrated similar functional recovery rates and speed compared to younger counterparts.
    • Pre-ICU functional status emerged as the primary determinant of post-ICU functional recovery, outweighing acute illness severity (APACHE II).
    • APACHE II scores were a significant correlate of mortality, highlighting the distinct roles of baseline function and acute illness severity in predicting patient outcomes.