Relationship between functional status prior to onset of critical illness and mortality: a prospective multicentre cohort study
| Autor: | R. Rivera-Lopez, E. Castillo-Lorente, D. Iglesias-Posadilla, M. Garcia-Delgado, C Lopez-Caler, R. Rivera-Fernandez, E. Aguilar-Alonso, R. Gutierrez-Rodriguez, Maria Dolores Arias-Verdú, Guillermo Quesada-García, J. E. Barrueco-Francioni |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Activities of daily living Critical Illness Glasgow Outcome Scale Critical Care and Intensive Care Medicine Cohort Studies 03 medical and health sciences 0302 clinical medicine Intensive care Internal medicine Activities of Daily Living medicine Humans 030212 general & internal medicine Hospital Mortality Prospective Studies Simplified Acute Physiology Score Prospective cohort study Aged business.industry 030208 emergency & critical care medicine Odds ratio Middle Aged Confidence interval ICU prognostic systems hospital mortality functional status Glasgow Outcome Scale score APACHE III score SAPS 3 score Anesthesiology and Pain Medicine Female business Cohort study |
| Zdroj: | ResearcherID Europe PubMed Central |
| ISSN: | 0310-057X |
| Popis: | This prospective study aimed to assess the association between prior functional status and hospital mortality for patients admitted to four intensive care units in Spain between 2006 and 2012. Prior functional status was classified into three groups, using a modification of the Glasgow Outcome Scale (GOS), including group 1 with no limitations on activities of daily living; group 2 with some limitations but self-sufficient; and group 3 who were dependent on others for their activities of daily living. Of the 1,757 patients considered (mean Simplified Acute Physiology Score [SAPS] predicted mortality 14.8% and hospital mortality 13.7%), group 1 had the lowest observed hospital mortality (8.3%) compared to the SAPS 3 predicted mortality (11.6%). The observed mortality for group 2 (20.6%) and group 3 (27.4%) were both higher than predicted (19.2% and 21.2% respectively; odds ratio [OR] 1.97, 95% confidence interval [CI] 1.38–2.82 for group 2 and OR 2.90, 95% CI 1.78–4.72 for group 3 compared to group 1). Combining prior functional status and Sequential Organ Failure Assessment (SOFA) score with SAPS 3 further improved the ability of the SAPS 3 scores in predicting hospital mortality (area under the receiver operating characteristic curve 0.85 [95% CI 0.82–0.88] versus 0.84 [95% CI 0.81–0.87] respectively). In summary, patients with limited functional status prior to ICU admission had a higher risk of observed hospital mortality than predicted. Assessing prior functional status using a relatively simple questionnaire, such as a modified GOS, has the potential to improve the accuracy of existing prognostic models. |
| Databáze: | OpenAIRE |
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