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 .
Predictive factors of in-hospital mortality in older patients admitted to a medical intensive care unit.
OBJECTIVES To identify prognostic factors that are independently predictive of in-hospital mortality in older patients hospitalized in a medical intensive care unit ( MICU ) . DESIGN Prospect i ve cohort study . SETTING A MICU in an Italian university hospital . PARTICIPANTS Patients aged 65 and older consecutively admitted to the MICU directly from the first-aid unit . MEASUREMENTS Upon admission , the following variables were examined : demographics , clinical history ( diabetes mellitus , active neoplasm , cognitive impairment , immobilization , pressure ulcers , use of nutritional support , home oxygen therapy ) , physiopathology ( Acute Physiology and Chronic Health Evaluation ( APACHE ) II ) , and cognition/function ( activity of daily living ( ADL ) , instrumental activity of daily living ( IADL ) , Short Portable Mental Status Question naire ( SPMSQ ) ) . The vital status of the patient at the end of hospitalization was recorded . RESULTS Over a period of 10 months , 659 patients were recruited ( mean age + /- st and ard deviation = 76.6 + /- 7.5 ; 352 men and 307 women ) . There were 97 deaths ( 14.71 % ) . The following factors proved to be significantly associated with in-hospital mortality : old age , low body mass index ( BMI ) values , low values of albumin , high scores on APACHE II , functional impairment ( ADL , IADL ) , cognitive impairment ( SPMSQ ) , history of cognitive deterioration , history of confinement to bed , and presence of pressure ulcers . Using multivariate analysis , the following variables were independently predictive of in-hospital mortality : lack of independence in ADLs ( P < .001 ) , moderate-to-severe cognitive impairment on SPMSQ ( P < .001 ) , score on APACHE II ( P = .002 ) , and low BMI values ( P = .031 ) . CONCLUSION The prognosis of older patients hospitalized in medical intensive care units depends not only on the acute physiological impairments , but also on a series of preexisting conditions , such as loss of functional independence , severe and moderate cognitive impairment , and low BMI
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 .