Evaluation of functional independence after discharge from the intensive care unit

Abstract

Objective1) To evaluate the functional independence measures immediately after discharge from an intensive care unit and to compare these values with the FIMs 30 days after that period. 2) To evaluate the possible associated risk factors. MethodsThe present investigation was a prospective cohort study that included individuals who were discharged from the intensive care unit and underwent physiotherapy in the unit. Functional independence was evaluated using the functional independence measure immediately upon discharge from the intensive care unit and 30 days thereafter via a phone call. The patients were admitted to the Hospital Santa Clara intensive care unit during the period from May 2011 to August 2011. ResultsDuring the predetermined period of data collection, 44 patients met the criteria for inclusion in the study. The mean age of the patients was 55.4±10.5 years. Twenty-seven of the subjects were female, and 15 patients were admitted due to pulmonary disease. The patients exhibited an functional independence measure of 84.1±24.2. When this measure was compared to the measure at 30 days after discharge, there was improvement across the functional independence variables except for that concerned with sphincter control. There were no significant differences when comparing the gender, age, clinical diagnosis, length of stay in the intensive care unit, duration of mechanical ventilation, and the presence of sepsis during this period. ConclusionFunctional independence, as evaluated by the functional independence measure scale, was improved at 30 days after discharge from the intensive care unit, but it was not possible to define the potentially related factors.

Avaliação funcional de pacientes internados na Unidade de Terapia Intensiva adulto do Hospital Universitário de Canoas

“…At the time of hospital discharge, most patients had achieved full independence, as in the data of Curzel et al 9 , which described improved functionality after 30 days of hospitalization. Curzel et al showed no significant difference in the comparison between MV time, length of stay, or pathological complications.…”

“…A mediana do tempo de internação na UTI foi de 5 (3)(4)(5)(6)(7)(8)(9) dias, e de internação hospitalar de 13 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) …”

“…Each activity received a score: 1 (functional dependence), 2 (maximum assistance), 3 (moderate assistance), 4 (minimum assistance), 5 (need of supervision), 6 (moderate independence) or 7 (complete independence). The total score ranged from 18 to 126 points 9 . Hand grip strength was measured by dynamometry.…”

Evaluation of functionality and quality of life in critical patients: case series report

“…A similar study 6 analyzed functional independence through FIM just after ICU discharge and 30 days later in 44 patients, and significant improvement was observed for all FIM areas, except regarding the control of sphincters and communication, which got the lower scores on discharge. After 30 days the lower scores in locomotion and the smallest loss was in self-care.…”

“…6 The Intensive Care Unit (ICU) is the hospital facility responsible for the care of severe and/or risky patients who require constant medical care, support from a multiprofessional team and specialized equipment to maintain life. 2 In this unit, there is a high incidence of sedatives, neuromuscular blockers and support.…”