Poor functional recovery after a critical illness: a longitudinal study

OBJECTIVE: To determine the time course of functional health status, and to inventory impairments in body functions, limitations in activities, and restrictions in participation after critical illness.

DESIGN: Prospective observational cohort study.

SETTING: Mixed medical and surgical closed format; intensive care unit of an academic medical hospital.

PATIENTS: Consecutive patients over a period of 3 months who were ventilated in the intensive care unit for more than 48 h (n = 116).

METHODS: Functional health status was assessed 3, 6 and 12 months after discharge from the intensive care unit using the Sickness Impact Profile 68. Impairments in function, limitations in activities, and restrictions in participation, classified according to the International Classification of Functioning, Disability, and Health (ICF), were evaluated after 3 and 12 months.

RESULTS: Due to a high mortality rate (48%) and poor health conditions, data could not be obtained from all participants at all measurement points. Physical functioning and social behaviour improved predominantly within the first 6 months, while impaired psychological functioning remained unchanged within one year after discharge from the intensive care unit. After one year, 69% of patients were still restricted in performing daily activities and only 50% had resumed work.

CONCLUSION: The extent and severity of lasting intensive care unit-related disability necessitates the development of multidisciplinary after-care to improve health status, functional independence and return to work.