Skip to main content
SpringerLink
Log in

Outcomes After Intensive Care: Functional Status

  • Chapter
  • First Online:
The Very Old Critically Ill Patients

Part of the book series: Lessons from the ICU ((LEICU))

  • 759 Accesses

Abstract

In this chapter we will first describe functional status by applying models well known to other medical disciplines but not commonly used to understand functional outcome after critical illness in the very old. We will then discuss instruments to capture functional status, particularly in old and very old people, and finally summarise important contributions of functional outcome after critical illness as reported in the literature.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. World Health Organization. International classification of functioning, disability and health: ICF [Internet]. Geneva: WHO; 2001. Available from: https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health.

    Google Scholar 

  2. Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129–36.

    Article  CAS  Google Scholar 

  3. ICF Research Branch. Creation of an ICF-based documentation form [Internet]. Nottwil: ICF Research Branch; 2021. Available from: https://www.icf-core-sets.org/en/page0.php.

    Google Scholar 

  4. Grill E, Hermes R, Swoboda W, Uzarewicz C, Kostanjsek N, Stucki G. ICF Core Set for geriatric patients in early post-acute rehabilitation facilities. Disabil Rehabil. 2005;27(7/8):411–7.

    Article  Google Scholar 

  5. Grill E, Müller M, Quittan M, Strobl R, Kostanjsek N, Stucki G. Brief ICF Core Set for patients in geriatric post-acute rehabilitation facilities. J Rehabil Med. 2011;43:139–44.

    Article  Google Scholar 

  6. Spoorenberg SLW, Reijneveld SA, Middel B, Uittenbroek RJ, Kremer HPH, Wynia K. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation. Disabil Rehabil. 2015;37(25):2337–43. https://doi.org/10.3109/09638288.2015.1024337.

    Article  PubMed  Google Scholar 

  7. Albrecht GL, Devlieger PJ. The disability paradox: high quality of life against all odds. Soc Sci Med. 1999;48(8):977–88.

    Article  CAS  Google Scholar 

  8. Wilson IB, Clearly PD. Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes. JAMA. 1995;273:59–65.

    Article  CAS  Google Scholar 

  9. Brummel NE. Measuring outcomes after critical illness. Crit Care Clin. 2018;34(4):515–26. https://doi.org/10.1016/j.ccc.2018.06.003.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Grill E, Stucki G. Scales could be developed based on simple clinical ratings of International Classification of Functioning, Disability and Health Core Set categories. J Clin Epidemiol. 2009;62:891–8.

    Article  Google Scholar 

  11. de Vriendt P, Lambert M, Mets T. Integrating the International Classification of Functioning, Disability and Health (ICF) in the Geriatric Minimum Data Set-25 (GMDS-25) for intervention studies in older people. J Nutr Health Aging. 2009;13(2):128–34. https://doi.org/10.1007/s12603-009-0019-8.

    Article  PubMed  Google Scholar 

  12. Allguren B, Bostan C, Christensson L, Fridlund B, Cieza A. A multidisciplinary cross-cultural measurement of functioning after stroke: Rasch analysis of the Brief ICF Core Set for Stroke. Top Stroke Rehabil. 2011;18(Suppl 1):573–86.

    Article  Google Scholar 

  13. Prodinger B, Tennant A, Stucki G. Standardized reporting of functioning information on ICF-based common metrics. Eur J Phys Rehabil Med. 2018;54:110–7. https://doi.org/10.23736/S1973-9087.17.04784-0.

    Article  PubMed  Google Scholar 

  14. Cornelis E, Gorus E, Beyer I, Bautmans I, De Vriendt P. Early diagnosis of mild cognitive impairment and mild dementia through basic and instrumental activities of daily living: development of a new evaluation tool. PLoS Med. 2017;14(3):e1002250. https://doi.org/10.1371/journal.pmed.1002250.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Parry SM, Huang M, Needham DM. Evaluating physical functioning in critical care: considerations for clinical practice and research. Crit Care. 2017;21:249. https://doi.org/10.1186/s13054-017-1827-6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychological function. JAMA. 1963;185:914–9.

    Article  CAS  Google Scholar 

  17. Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61–5.

    CAS  PubMed  Google Scholar 

  18. den Ouden ME, Schuurmans MJ, Mueller-Schotte S, Brand JS, van der Schouw YT. Domains contributing to disability in activities of daily living. J Am Med Dir Assoc. 2013;14(1):18–24. https://doi.org/10.1016/j.jamda.2012.08.014.

    Article  Google Scholar 

  19. Demers L, Desrosiers J, Ska B, Wolfson N, Nikolova R, Pervieux I, et al. Assembling a toolkit to measure geriatric rehabilitation outcomes. Am J Phys Med Rehabil. 2005;84:460–72.

    Article  Google Scholar 

  20. Buurman BM, van Munster BC, Korevaar JC, de Haan RJ, de Rooij SE. Variability in measuring (instrumental) activities of daily living functioning and functional decline in hospitalized older medical patients: a systematic review. J Clin Epidemiol. 2011;64(6):619–27. https://doi.org/10.1016/j.jclinepi.2010.07.005.

    Article  PubMed  Google Scholar 

  21. Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen MLG, Extermann M, et al. International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol. 2014;32(24):2595–603. https://doi.org/10.1200/JCO.2013.54.8347.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hayes JA, Black NA, Jenkinson C, Young JD, Rowan KM, Daly K, et al. Outcome measures for adult critical care: a systematic review. Health Technol Assess. 2000;4:1e111.

    Article  Google Scholar 

  23. Turnbull AE, Rabiee A, Davis WE, Nasser MF, Venna VR, Lolitha R, et al. Outcome measurement in ICU survivorship research from 1970 to 2013: a scoping review of 425 publications. Crit Care Med. 2016;44(7):1267–77.

    Article  Google Scholar 

  24. Robinson KA, Davis WE, Dinglas VD, Mendez-Tellez PA, Rabiee A, Sukrithan V, et al. A systematic review finds limited data on measurement properties of instruments measuring outcomes in adult intensive care unit survivors. J Clin Epidemiol. 2017;82:37–46. https://doi.org/10.1016/j.jclinepi.2016.08.014.

    Article  PubMed  Google Scholar 

  25. Blackwood B, Marshall J, Rose L. Progress on core outcome sets for critical care research. Curr Opin Crit Care. 2015;21:439e44.

    Article  Google Scholar 

  26. Dinglas VD, Cherukin SPS, Needham DM. Core outcomes sets for studies evaluating critical illness and patient recovery. Curr Opin Crit Care. 2020;26:489–99. https://doi.org/10.1097/MCC.0000000000000750.

    Article  PubMed  PubMed Central  Google Scholar 

  27. The COMET initiative. Core outcome measures in effectiveness trials [Internet]. Liverpool: COMET; 2021. Available from: https://www.comet-initiative.org/.

    Google Scholar 

  28. Improving Long-Term Outcomes Research for Acute Respiratory Failure. Core outcome measurement set (COMS) [Internet]. US: Baltimore; 2021. https://www.improvelto.com/coms/.

    Google Scholar 

  29. Akpan A, Roberts C, Bandeen-Roche K, Batty B, Bausewein C, Bell D, et al. Standard set of health outcome measures for older persons. BMC Geriatr. 2018;18(1):36. https://doi.org/10.1186/s12877-017-0701-3.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Riegel B, Huang L, Mikkelsen ME, Kutney-Lee A, Hanlon AL, Murtaugh CM, et al. Early Post-Intensive Care Syndrome among older adult sepsis survivors receiving home care. J Am Geriatr Soc. 2019;67(3):520–6. https://doi.org/10.1111/jgs.15691.

    Article  PubMed  Google Scholar 

  31. Mahul P, Perrot D, Tempelhoff G, Gaussorgues P, Jospe R, Ducreux JC, et al. Short- and long-term prognosis, functional outcome following ICU for elderly. Intensive Care Med. 1991;17:7–10.

    Article  CAS  Google Scholar 

  32. Ingraham NE, Vakayil V, Pendleton KM, Robbins AJ, Freese RL, Northrop EF, et al. National trends and variation of functional status deterioration in the medically critically ill. Crit Care Med. 2020;48(11):1556–64. https://doi.org/10.1097/CCM.0000000000004524.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE. Cohort profile: the Precepitating Events Project (PEP Study). J Nutr Health Aging. 2020;24(4):438–44.

    Article  CAS  Google Scholar 

  34. Ferrante LE, Pisani MA, Murphy TE, Gahbauer EA, Leo-Summers LS, Gill TM. Functional trajectories among older persons before and after critical illness. JAMA Intern Med. 2015;175(4):523–9. https://doi.org/10.1001/jamainternmed.2014.7889.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Ferrante LE, Pisani MA, Murphy TE, Gahbauer EA, Leo-Summers LS, Gill TM. Factors associated with functional recovery among older intensive care unit survivors. Am J Respir Crit Care Med. 2016;194(3):299–307.

    Article  Google Scholar 

  36. Ferrante LE, Murphy TE, Gahbauer EA, Leo-Summers LS, Pisani MA, Gill TM. Pre–intensive care unit cognitive status, subsequent disability, and new nursing home admission among critically ill older adults. Ann Am Thorac Soc. 2018;15(5):622–9. https://doi.org/10.1513/AnnalsATS.201709-702OC.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Ferrante LE, Pisani MA, Murphy TE, Gahbauer EA, Leo-Summers LS, Gill TM. The association of frailty with post-ICU disability, nursing home admission, and mortality. A longitudinal study. Chest. 2018;153(6):1378–86. https://doi.org/10.1016/j.chest.2018.03.007.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ferrante LE, Murphy TE, Gahbauer EA, Leo-Summers LS, Pisani MA, Gill TM. The combined effects of frailty and cognitive impairment on post-ICU disability among older ICU survivors. Am J Respir Crit Care Med. 2019;200(1):107–10. https://doi.org/10.1164/rccm.201806-1144LE.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE, Ferrante LE. Functional effects of intervening illnesses and injuries after critical illness in older persons. Crit Care Med. 2021;49(6):956–66. https://doi.org/10.1097/CCM.0000000000004829.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Heyland DK, Garland A, Bagshaw SM, Cook D, Rockwood K, Stelfox HT. Recovery after critical illness in patients aged 80 years or older: a multi-center prospective observational cohort study. Intensive Care Med. 2015;41(11):1911–20. https://doi.org/10.1007/s00134-015-4028-2.

    Article  PubMed  Google Scholar 

  41. Heyland DK, Stelfox HT, Garland A, Cook D, Dodek P, Kutsogiannis J, et al. Predicting performance status 1 year after critical illness in patients 80 years or older: development of a multivariable clinical prediction model. Crit Care Med. 2016;44(9):1718–26. https://doi.org/10.1097/CCM.0000000000001762.

    Article  PubMed  Google Scholar 

  42. Broslawski GE, Elkins M, Algus M. Functional abilities of elderly survivors of intensive care. J Am Osteopath Assoc. 1995;95:712–7.

    CAS  PubMed  Google Scholar 

  43. Boumendil A, Maury E, Reinhard I, Luquel L, Offenstadt G, Guidet B. Prognosis of patients aged 80 years and over admitted in medical intensive care unit. Intensive Care Med. 2004;30:647–54.

    Article  Google Scholar 

  44. Daubin C, Chevalier S, Séguin A, Gaillard C, Valette X, Prévost F, et al. Predictors of mortality and short-term physical and cognitive dependence in critically ill persons 75 years and older: a prospective cohort study. Health Qual Life Outcomes. 2011;9:35.

    Article  Google Scholar 

  45. Sacanella E, Pérez-Castejón JM, Nicolás JM, Masanés F, Navarro M, Castro P, López-Soto A. Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study. Crit Care. 2011;15:R105.

    Article  Google Scholar 

  46. Demiselle J, Duval G, Hamel J-F, Renault A, Bodet-Contentin L, Martin-Lefèvre L, et al. Determinants of hospital and one-year mortality among older patients admitted to intensive care units: results from the multicentric SENIOREA cohort. Ann Intensive Care. 2021;11:35.

    Article  Google Scholar 

  47. Hajeb M, Singh TD, Sakusic A, Graff-Radford J, Gajic O, Rabinstein AA. Functional outcome after critical illness in older patients: a population-based study. Neurol Res. 2021;43(2):103–9. https://doi.org/10.1080/01616412.2020.1831302.

    Article  PubMed  Google Scholar 

  48. Pietiläinen L, Hästbacka J, Bäcklund M, Parviainen I, Pettilä V, Reinikainen M. Premorbid functional status as a predictor of 1-year mortality and functional status in intensive care patients aged 80 years or older. Intensive Care Med. 2018;44:1221–9. https://doi.org/10.1007/s00134-018-5273-y.

    Article  PubMed  Google Scholar 

  49. Montuclard L, Garrouste-Orgeas M, Timsit J-F, Misset B, de Jonghe B, Carlet J. Outcome, functional autonomy, and quality of life of elderly patients with a long-term intensive care unit stay. Crit Care Med. 2000;28:3389–95.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Anaesthesia and Intensive Care, Heart Centre, Linköping University Hospital, Linköping, Sweden

    Sten M. Walther

  2. Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden

    Sten M. Walther

Authors
  1. Sten M. Walther
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sten M. Walther .

Editor information

Editors and Affiliations

  1. Faculty of Medicine, Department of Clinical Medicine and Department of Anaesthesia and Intensive Care, University of Bergen and Haukeland University Hospital, Bergen, Norway

    Hans Flaatten

  2. Sorbonne Université, INSERM Institut Pierre Louis d’Epidémiologie et de, Santé Publique, AP-HP, Hôpital Saint Antoine, Paris, France

    Bertrand Guidet

  3. Sorbonne Université, Hôpital Saint Antoine Unité de Gériatrie Aiguë, Assistance Publique, Hôpitaux de Paris, Paris, France

    Hélène Vallet

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Walther, S.M. (2022). Outcomes After Intensive Care: Functional Status. In: Flaatten, H., Guidet, B., Vallet, H. (eds) The Very Old Critically Ill Patients. Lessons from the ICU. Springer, Cham. https://doi.org/10.1007/978-3-030-94133-8_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-94133-8_25

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-94132-1

  • Online ISBN: 978-3-030-94133-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation