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Titre : | Decline in functional status after intensive care unit discharge is associated with ICU readmission: a prospective cohort study (2019) |
Auteurs : | Leda Tomiko Yamada da Silveira ; Janete Maria da Silva ; Clarice Tanaka |
Type de document : | Article |
Dans : | Physiotherapy (Vol. 105, n° 3, 2019) |
Article en page(s) : | p. 321-327 |
Note générale : | https://doi.org/10.1016/j.physio.2018.07.010 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Activités de la vie quotidienne ; Réadaptation ; Réadmission du patient ; Soins de réanimation ; Techniques de physiothérapie |
Résumé : |
Objectives
To compare the functional status at intensive care unit (ICU) discharge of patients who were later readmitted to the ICU and patients discharged home and to verify whether a decline in functional status is associated with ICU readmission. Design Prospective cohort study. Setting ICU at a tertiary teaching hospital. Participants Patients admitted to the ICU, ≥18 years old, submitted to invasive mechanical ventilation (IMV), and discharged to the ward. Interventions Functional assessment at ICU discharge. Discharge Group (DG) (patients discharged home) and Readmission Group (RG) (patients who returned to the ICU) were compared with MannWhitney and Chi-square or Exact Fisher tests. Multiple logistic regression verified association. Main outcome measures Barthel Index, key pinch strength, clinical and demographic data. Results Patients in the readmission group presented lower Barthel Index [Median 40 (IQR 2075) vs 60 (3383), P = 0.033], greater relative variation (pre and post ICU) of the Barthel Index (P = 0.04), lower key pinch strength [3.4 (1.84.5) vs 4.5 (2.76.8) kg·f, P = 0.006] and higher APACHE II [18 (1222) vs 15 (1120), P = 0.027]. Multiple regression found that the relative variation of the Barthel Index was independently associated with ICU readmission (P Conclusion Readmitted patients presented poorer functional status and lower pinch strength. Relative variation of the Barthel Index was associated with ICU readmission despite other factors, as was higher APACHE II, shorter IMV duration and admission without clear diagnosis. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S003194061830169X |