Functional status after intensive care: a challenge for rehabilitation professionals to improve outcome

J Rehabil Med. 2009 Apr;41(5):360-6. doi: 10.2340/16501977-0333.


Objective: To examine restrictions in daily functioning from a rehabilitation perspective in patients one year after discharge from the intensive care unit, and to identify prognostic factors for functional status.

Design: Cross-sectional design.

Patients: Consecutive patients who were admitted to the intensive care unit for more than 48 h (n = 255).

Methods: One year after intensive care, functional status (Sickness Impact Profile) as primary outcome, and Quality of Life (SF-36), anxiety and depression (Hospital Anxiety Depression Scale), and post-traumatic stress disorder (Impact of Events Scale) were evaluated.

Results: Fifty-four percent of the patients had restrictions in daily functioning. Walking and social activities were most frequently restricted (30-60% of the patients). Quality of life was lower than the general Dutch population. Symptoms of anxiety and depression were found in 14%, and post-traumatic stress disorder in 18%. Severity of illness at admission and length of stay in the intensive care unit were identified as prognostic factors, although they explained only 10% of functional status.

Conclusion: The high prevalence of long-lasting restrictions in physical, social and psychological functioning among patients who stayed in the intensive care unit for at least 2 days implies that these patients are a potential target population for rehabilitation medicine. Multidisciplinary therapies need to be developed and evaluated in order to improve outcome.

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Critical Care
  • Critical Illness / psychology
  • Critical Illness / rehabilitation*
  • Critical Illness / therapy
  • Cross-Sectional Studies
  • Depression / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Discharge
  • Prognosis
  • Quality of Life
  • Sickness Impact Profile
  • Stress Disorders, Post-Traumatic / etiology
  • Surveys and Questionnaires
  • Time Factors
  • Young Adult