与重症监护室幸存者身体功能损伤相关的社会人口因素的探索性分析。

Q4 Medicine Critical care explorations Pub Date : 2024-06-05 eCollection Date: 2024-06-01 DOI:10.1097/CCE.0000000000001100
Megan A Watson, Marie Sandi, Johanna Bixby, Grace Perry, Patrick J Offner, Ellen L Burnham, Sarah E Jolley
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引用次数: 0

摘要

重要性:身体功能障碍是重症监护后综合征(PICS)的三个组成部分之一,多达 60% 的重症监护室幸存者会受到影响:目的:探讨不同群体的 ICU 幸存者在出院时和纵向客观身体功能障碍的发生率,并强调可能与客观身体功能障碍相关的社会人口因素:这是对2016年至2019年期间路易斯安那州新奥尔良市和科罗拉多州丹佛市重症监护室收治的37名患者进行的二次分析,这些患者存活下来,并提供了纵向随访数据:我们的主要结果是肢体功能障碍,由手握强度和短期体能表现电池定义。我们探讨了功能障碍与社会人口学因素(包括种族/民族、性别、主要语言、教育状况和医疗合并症)之间的关联:结果:超过 75% 的重症监护室幸存者在出院时和 3 至 6 个月的纵向随访中受到身体功能障碍的影响。不同种族/民族、主要语言或教育程度的患者身体功能受损的比例没有明显差异。与男性和合并症患者相比,女性患者在随访期间的功能受损程度相对较高。在两个时间点均有得分的 18 名患者中,白人患者的手握力变化比非白人患者更大。四名非白人患者在出院和随访期间的手握力有所减弱:在这项探索性分析中,我们发现 ICU 幸存者中客观身体功能障碍的发生率很高,并且在出院后仍持续存在。我们的研究结果表明,种族/民族与身体功能障碍之间可能存在关系。这些探索性发现可为今后评估社会人口因素对功能恢复的影响提供参考。
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An Exploratory Analysis of Sociodemographic Factors Associated With Physical Functional Impairment in ICU Survivors.

Importance: Physical functional impairment is one of three components of postintensive care syndrome (PICS) that affects up to 60% of ICU survivors.

Objectives: To explore the prevalence of objective physical functional impairment among a diverse cohort of ICU survivors, both at discharge and longitudinally, and to highlight sociodemographic factors that might be associated with the presence of objective physical functional impairment.

Design, setting, and participants: This was a secondary analysis of 37 patients admitted to the ICU in New Orleans, Louisiana, and Denver, Colorado between 2016 and 2019 who survived with longitudinal follow-up data.

Main outcomes and measures: Our primary outcome of physical functional impairment was defined by handgrip strength and the short physical performance battery. We explored associations between functional impairment and sociodemographic factors that included race/ethnicity, sex, primary language, education status, and medical comorbidities.

Results: More than 75% of ICU survivors were affected by physical functional impairment at discharge and longitudinally at 3- to 6-month follow-up. We did not see a significant difference in the proportion of patients with physical functional impairment by race/ethnicity, primary language, or education status. Impairment was relatively higher in the follow-up period among women, compared with men, and those with comorbidities. Among 18 patients with scores at both time points, White patients demonstrated greater change in handgrip strength than non-White patients. Four non-White patients demonstrated diminished handgrip strength between discharge and follow-up.

Conclusions and relevance: In this exploratory analysis, we saw that the prevalence of objective physical functional impairment among ICU survivors was high and persisted after hospital discharge. Our findings suggest a possible relationship between race/ethnicity and physical functional impairment. These exploratory findings may inform future investigations to evaluate the impact of sociodemographic factors on functional recovery.

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