Conclusions There is considerable variability in the type of measures utilized to measure physical impairments and limitations in survivors of critical illness .
Purpose To identify measures used to evaluate the broad constructs of functional impairment and limitations in the critically ill across the continuum of recovery , and to evaluate , synthesis e and compare the clinimetric properties of the measures identified .
The Clinical Utility of the Functional Status Score for the Intensive Care Unit (FSS-ICU) at a Long-Term Acute Care Hospital: A Prospective Cohort Study
Background and Purpose Long-term acute care hospitals ( LTACHs ) have emerged for patients requiring medical care beyond a short stay . Minimal data have been reported on functional outcomes in this setting . The purpose s of this study were : ( 1 ) to measure the clinical utility of the Functional Status Score for the Intensive Care Unit ( FSS-ICU ) in an LTACH setting and ( 2 ) to explore the association between FSS-ICU score and discharge setting . Participants Data were obtained from 101 patients ( median age=70 years , interquartile range [IQR]=61–78 ; 39 % female , 61 % male ) who were admitted to an LTACH . Participants were categorized into 1 of 5 groups by discharge setting : ( 1 ) home ( n=14 ) , ( 2 ) inpatient rehabilitation facility ( n=26 ) , ( 3 ) skilled nursing facility ( n=23 ) , ( 4 ) long-term care/hospice/expired ( n=13 ) , or ( 5 ) transferred to a short-stay hospital ( n=25 ) . Methods Data were prospect ively collected from a 38-bed LTACH in the United States over 8 months beginning in September 2010 .  Functional status was scored using the FSS-ICU within 4 days of admission and every 2 weeks until discharge . The FSS-ICU consists of 5 categories : rolling , supine-to-sit transfers , unsupported sitting , sit-to-st and transfers , and ambulation . Each category was rated from 0 to 7 , with a maximum cumulative FSS-ICU score of 35 . Results Cumulative FSS-ICU scores significantly improved from a median ( IQR ) of 9 ( 3–17 ) to 14 ( 5–24 ) at discharge . Median ( IQR ) cumulative discharge FSS-ICU scores were significantly different among the discharge categories : home=28 ( 22–32 ) , inpatient rehabilitation facility=21 ( 15–24 ) , skilled nursing facility=14 ( 8–21 ) , long-term care/hospice/expired=5 ( 0–11 ) , and transfer to a short-stay hospital=4 ( 0–7 ) . Discussion and Conclusions Patients receiving therapy at an LTACH demonstrate significant improvements from admission to discharge using the FSS-ICU . This outcome tool discriminates among discharge setting s and successfully documents functional improvements of patients in an LTACH setting
Conclusions There is considerable variability in the type of measures utilized to measure physical impairments and limitations in survivors of critical illness .
Purpose To identify measures used to evaluate the broad constructs of functional impairment and limitations in the critically ill across the continuum of recovery , and to evaluate , synthesis e and compare the clinimetric properties of the measures identified .