Validation of a New Clinical Tool for Post-Intensive Care Syndrome.
Sophia Wang, Duane Allen, Anthony Perkins and 5 others
PMID 30600222WHAT IT FOUND
The HABC-M SR self-report tracked psychological and functional symptoms in ICU survivors, but its cognitive subscale did not consistently match formal cognitive testing.
Use it to flag symptoms, not to clear cognition.
Key findings
01The psychological subscale had the strongest correlations with standardized depression and PTSD measures, and the functional subscale correlated with a physical self-maintenance measure.
02The cognitive subscale did not correlate with RBANS measures and only correlated with delayed memory on the CERAD battery.
03ICU survivor clinic patients had worse HABC-M SR total and subscale scores than primary care patients.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The analysis included only patients who completed both the self-report and standardized testing, so many recruited patients were not analysed. The study used retrospective data from one ICU survivor clinic, so it may not apply to other clinics or primary care settings. The HABC-M SR was only suitable for patients with normal cognition, mild cognitive impairment, or early-stage dementia, not moderate or severe dementia. The cognitive subscale did not track formal cognitive testing well, so it should not be used alone to rule out cognitive impairment. The functional subscale did not directly correlate with physical impairments in PICS. The comparison group was an older primary care validation sample, not a general population. Telephone and internet administration were not validated in this study.
The easy way to misread this
Do not treat a normal HABC-M SR cognitive subscale score as proof that an ICU survivor has no cognitive impairment. The cognitive subscale did not correlate with the RBANS battery and only correlated with delayed memory on the CERAD battery, so clinicians should still evaluate cognitive concerns based on history and examination.