Abstract / Description of output
Introduction: Level one evidence supports improvement in physical function at hospital discharge following rehabilitation for critically ill adults. The effect beyond hospital discharge is unclear. Objectives: In our search for who responds to rehabilitation, the primary objective was to explore if patient characteristics (comorbidity, age, sex and illness severity) of critically ill adults modify the co-primary outcomes of physical function and health-related quality of life (HRQoL).
Methods: Principal investigators of randomiced rehabilitation trials that included assessment of comorbidity, physical function and HRQoL with a minimum follow up period of three months were invited to contribute data of individual participants to this study (systematic review and individual participant data meta-analysis).
Results: Four trials from the United States, United Kingdom and Australia contributed data from individual participants (n¼810). The presence of comorbidities modified the outcome of rehabilitation for the Physical Component Summary (PCS) score of HRQoL. Participants with two or more comorbidities (Functional Comorbidity Index score 3 2) had PCS scores below normative values (mean 50 ± 10) which improved following the intervention at three (effect estimate (95% CI) intervention vs control: 36.2 (34.4 to 38.1) vs 30.4 (28.3 to 32.6)) and 6 months (38.3 (36.4 to 40.1) vs 32.5 (30.4 to 34.6)) but not 12 months (p¼0.04). No other patient characteristic modified the outcome of rehabilitation for PCS score nor for any measure of physical function.
Conclusion(s): This is the first study in the field to combine trial data of individual participants. The presence of comorbidities modified the outcome of rehabilitation. Identification of a target group of critically ill patients with two or more comorbidities provides direction clinically and for future research
Methods: Principal investigators of randomiced rehabilitation trials that included assessment of comorbidity, physical function and HRQoL with a minimum follow up period of three months were invited to contribute data of individual participants to this study (systematic review and individual participant data meta-analysis).
Results: Four trials from the United States, United Kingdom and Australia contributed data from individual participants (n¼810). The presence of comorbidities modified the outcome of rehabilitation for the Physical Component Summary (PCS) score of HRQoL. Participants with two or more comorbidities (Functional Comorbidity Index score 3 2) had PCS scores below normative values (mean 50 ± 10) which improved following the intervention at three (effect estimate (95% CI) intervention vs control: 36.2 (34.4 to 38.1) vs 30.4 (28.3 to 32.6)) and 6 months (38.3 (36.4 to 40.1) vs 32.5 (30.4 to 34.6)) but not 12 months (p¼0.04). No other patient characteristic modified the outcome of rehabilitation for PCS score nor for any measure of physical function.
Conclusion(s): This is the first study in the field to combine trial data of individual participants. The presence of comorbidities modified the outcome of rehabilitation. Identification of a target group of critically ill patients with two or more comorbidities provides direction clinically and for future research
Original language | English |
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Pages (from-to) | S18-S18 |
Journal | Australian Critical Care |
Volume | 35 |
Issue number | Supplement 1 |
DOIs | |
Publication status | Published - 30 Sept 2022 |
Event | The ANZICS/ACCCN Intensive Care Annual Scientific Meeting - Sydney, Australia Duration: 27 Apr 2022 → 29 Apr 2022 |