Reduced physical functional performance before hospitalization predicts life support limitations and mortality in nonsurgical intensive care unit patients

Jamile Caroline Garbuglio Araujo da Silva*, Tiago Giraldi, Carolina Matida Gontijo Coutinho, Marco Antonio Carvalho Filho, Dario Cecílio Fernandes, Thiago Martins Santos

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Objective: 

To assess whether scales of physical functional performance and the surprise question (“Would I be surprised if this patient died in 6 months?”) predict life support limitations and mortality in critically ill nonsurgical patients. 

Methods: 

We included 114 patients admitted from the Emergency Department to an intensive care unit in this prospective cohort. Physical functional performance was assessed by the Palliative Prognostic Score, Karnofsky Performance Status, and the Katz Activities of Daily Living scale. Two intensivists responded to the surprise question. 

Results: 

The proposed physical functional performance scores were significantly lower in patients with life support limitations and those who died during the hospital stay. A negative response to the surprise question was more frequent in the same subset of patients. Adjusted univariable analysis showed an increased odds ratio for life support limitations and death regarding the activities of daily living scale (1.35 [1.01 - 1.78] and 1.34 [1.0 - 1.79], respectively) and a negative response for the surprise question (42.35 [11.62 - 154.43] and 47.79 [11.41 - 200.25], respectively); with a p < 0.05 for all results. 

Conclusion: 

All physical functional performance scales showed lower scores in nonsurvivors and patients with life support limitations. The activities of daily living score and the surprise question increased the odds of life support limitations and mortality in our cohort of nonsurgical intensive care unit patients admitted from the Emergency Department.

Original languageEnglish
JournalRevista Brasileira de Terapia Intensiva
Volume34
Issue number1
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© 2022 Associacao de Medicina Intensiva Brasileira - AMIB. All rights reserved.

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