OBJECTIVES: To assess symptoms in older intensive care unit (ICU) survivors and determine whether post-ICU frailty identifies those with the greatest palliative care needs.
DESIGN: A prospective cohort study.
SETTING: Urban tertiary care hospital and community hospital.
PARTICIPANTS: Medical ICU survivors of mechanical ventilation aged 65 and older.
MEASUREMENTS: Baseline measurements of age, sex, race, ethnicity, religion, insurance, discharge location, smoking history, Edmonton Symptom Assessment Scale (ESAS), Charlson Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation (APACHE-II), mechanical ventilation, length of ICU stay, confusion assessment method (CAM-ICU), mini-cog, pre-hospitalization disability (Katz), brief fatigue index (BFI), patient health questionnaire 9 (PHQ-9), insomnia severity index (ISI), hospice questions, frailty measurements, other strength measures, and serologic measures. Re-hospitalization, DNR status, Barthel Index, Katx, EQ5D, and Family Evaluation of Treatment at End of Life Short Form (FATE-S) were assessed at 1, 3, and 6 months after hospital discharge. The ESAS, BFI, PHQ-9, and ISI were also reassessed at 1 month post discharge.
Analysis and data cleaning code (STATA), research protocol/handbook
Baldwin MR et al. Refining Low Physical Activity Measurement Improves Frailty Assessment in Advanced Lung Disease and Survivors of Critical Illness. Annals of the American Thoracic Society. 2017;14(8):1270-9.
Please note, 23 participants from pilot study did not have all measures collected; there were 166 participants from the non-pilot study, 118 of which had palliative care assessments and the remainder with frailty and follow up data only.