Changes in biopsychosocial outcomes for a mixed cohort of ICU survivors.
Johannes van Aartsen, Helena van Aswegen
PMID 30135920WHAT IT FOUND
Physical quality of life scores improved over 6 months among 24 ICU survivors.
Muscle strength scores changed, while walking distance and mental health changed less clearly, and depression screening stayed mild.
Key findings
01The SF-36 physical component score was 42.9 at 1 month and 51.7 at 6 months, and the paper reported a significant difference of 8.8 points.
02The median 6-minute walk distance was 425 m at 1 month and 490 m at 6 months, and the 65 m change was not significant.
03At 6 months, 6 of 11 participants assessed had returned to employment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 24 participants were enrolled, and the study did not reach its projected sample size of 163. Follow-up was incomplete: 15 participants were assessed at 1 month and 11 at 6 months, with reported drop-out rates of 37.5% and 54.2%. There was no control group, and all participants received physiotherapy during hospital stay, so the study cannot separate the effect of any specific treatment. The cohort was mixed, including medical, trauma and surgical admissions, so results may not apply to one ICU diagnosis. No pre-admission baseline scores for physical function or psychological health were available, so post-discharge changes cannot be compared with each person's usual function. Respiratory muscle strength was not assessed, so breathing muscle weakness may have influenced walking test performance. The 6-minute walk test used a 10-m track because of space, which differs from the standard test length. The PHQ-9 depression screen was available only in English, although other questionnaires were translated. Associations between muscle strength and length of stay or severity of illness were not analysed. Somatic symptoms and their relation to mental quality of life were not investigated.
Declared interests
No funding or conflict-of-interest declaration is reported. The paper states that Quality Metrics provided the SF-36 scoring software and licence through Optum Insight Life Sciences Inc.
The easy way to misread this
Do not read the 6-month gains in strength and quality of life as proof that a particular rehabilitation programme caused them. This was an observational cohort of 24 people with no control group, and all participants received physiotherapy during hospital stay.