Physical impairment and perceived general health preceding critical illness is predictive of survival

Abstract

Purpose: We hypothesized that item response based assessment of physical reserve preceding ICU admission is a predictor of survival.

Methods: We evaluated physical functioning using the Academic Medical Center Linear Disability Score (ALDS) and quality of life using the first question (SF-1) and the physical component score (PCS-12) from the Short-form 12 (SF-12) before admission by patients or by close proxies within 72 h after ICU admission during 1 year.

Results: We developed four logistic regression models to predict 1 year mortality using the predictors age, gender, ALDS, SF-1, PCS-12. A total of 510 patients participated. Twelve months after ICU discharge, 110 patients (22%) had died. Pre-admission ALDS (p = .004), and SF-1 (p = .012) improved the prediction models with age and gender PCS-12 showed no association with mortality (p = .062). Adding the ALDS (p = .049) and the SF-1 (p = .048) to a model with age, gender and the APACHE II score (improved the model. Adding PCS-12 showed no association with mortality (p = .355).

Conclusions: Physical reserve as assessed by ALDS and perceived general health, preceding ICU admission is predictive of mortality. Obtaining patient's physical reserve or pre-existing perceived general health should be part of routine assessment whether a patient may benefit from ICU admission.

Keywords: Critical illness; Mortality; Nomogram; Outcome; Physical reserve.