The sit-to-stand test as a patient-centered functional outcome for critical care research: a pooled analysis of five international rehabilitation studies
- Author(s)
- O'Grady, HK; Edbrooke, L; Farley, C; Berney, S; Denehy, L; Puthucheary, Z; Kho, ME; International METRIC Critical Care Data Group;
- Journal Title
- Critical Care
- Publication Type
- Research article
- Abstract
- BACKGROUND: With ICU mortality rates decreasing, it is increasingly important to identify interventions to minimize functional impairments and improve outcomes for survivors. Simultaneously, we must identify robust patient-centered functional outcomes for our trials. Our objective was to investigate the clinimetric properties of a progression of three outcome measures, from strength to function. METHODS: Adults (>/= 18 years) enrolled in five international ICU rehabilitation studies. Participants required ICU admission were mechanically ventilated and previously independent. Outcomes included two components of the Physical Function in ICU Test-scored (PFIT-s): knee extensor strength and assistance required to move from sit to stand (STS); the 30-s STS (30 s STS) test was the third outcome. We analyzed survivors at ICU and hospital discharge. We report participant demographics, baseline characteristics, and outcome data using descriptive statistics. Floor effects represented >/= 15% of participants with minimum score and ceiling effects >/= 15% with maximum score. We calculated the overall group difference score (hospital discharge score minus ICU discharge) for participants with paired assessments. RESULTS: Of 451 participants, most were male (n = 278, 61.6%) with a median age between 60 and 66 years, a mean APACHE II score between 19 and 24, a median duration of mechanical ventilation between 4 and 8 days, ICU length of stay (LOS) between 7 and 11 days, and hospital LOS between 22 and 31 days. For knee extension, we observed a ceiling effect in 48.5% (160/330) of participants at ICU discharge and in 74.7% (115/154) at hospital discharge; the median [1st, 3rd quartile] PFIT-s difference score (n = 139) was 0 [0,1] (p < 0.05). For STS assistance, we observed a ceiling effect in 45.9% (150/327) at ICU discharge and in 77.5% (79/102) at hospital discharge; the median PFIT-s difference score (n = 87) was 1 [0, 2] (p < 0.05). For 30 s STS, we observed a floor effect in 15.0% (12/80) at ICU discharge but did not observe a floor or ceiling effect at hospital discharge. The median 30 s STS difference score (n = 54) was 3 [1, 6] (p < 0.05). CONCLUSION: Among three progressive outcome measures evaluated in this study, the 30 s STS test appears to have the most favorable clinimetric properties to assess function at ICU and hospital discharge in moderate to severely ill participants.
- Keywords
- Adult; Aged; *Critical Care; Critical Illness/rehabilitation; Female; Humans; *Intensive Care Units; Length of Stay; Male; Middle Aged; Patient-Centered Care; Physical Therapy Modalities; Respiration, Artificial; Critical illness; Exercise test; Intensive care units; Outcome assessment; Physical outcome measures; Rehabilitation; Sit-to-stand test
- Department(s)
- Health Services Research
- PubMed ID
- 35698237
- Publisher's Version
- https://doi.org/10.1186/s13054-022-04048-3
- Open Access at Publisher's Site
https://doi.org/10.1186/s13054-022-04048-3- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-02-14 04:06:02
Last Modified: 2025-02-14 04:08:15