Inability to Sit-to-Stand in Medical ICUs Survivors: When and Why We Should Care.
Journal
Critical care medicine
ISSN
1530-0293
Date Issued
2024-09-11
Author(s)
Abstract
OBJECTIVES: To investigate the prevalence and association with mortality of inability to perform sit-to-stand independently in critically ill survivors 3 months following medical ICU (MICU) discharge. DESIGN: Prospective cohort study. SETTING: Six MICUs at a tertiary care hospital. PATIENTS: MICU survivors who could sit-to-stand independently before the index hospitalization. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Inability to sit-to-stand (yes/no) was measured at four points following MICU discharge: upon ICU discharge, 1, 2, and 3 months afterward. Mortality was evaluated at 6- and 12-month post-MICU discharge. Among 194 participants, 128 (66%) had inability to sit-to-stand upon MICU discharge. Recovery occurred, with rates decreasing to 50% at 1 month, 38% at 2 months, and 36% at 3 months post-MICU discharge, plateauing at 2 months. Inability to sit-to-stand at 3 months was significantly associated with 21% mortality at 12 months and a 4.2-fold increased risk of mortality (adjusted hazard ratio, 4.2; 95% CI, 1.61-10.99), independent of age, Sequential Organ Failure Assessment score, and ICU-acquired weakness. Notably, improvement in sit-to-stand ability, even from “totally unable” to “able with assistance,” correlates with reduced mortality risk. CONCLUSIONS: Inability to sit-to-stand affects about 36% of MICU survivors even at 3 months post-ICU discharge, highlighting rehabilitation challenges. Revisiting sit-to-stand ability post-ICU discharge is warranted. Additionally, using sit-to-stand as a screening tool for interventions to improve return of its function and mortality is suggested.
SDGs
Type
journal article