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我存活了:三种 ICU 幸存者身体功能结局测量工具的评定者间信度。

I SURVIVE: inter-rater reliability of three physical functional outcome measures in intensive care unit survivors.

机构信息

Physiotherapy Department, St. Joseph's Healthcare, Hamilton, ON, Canada.

Department of Medicine (Division of Critical Care), McMaster University, Hamilton, ON, Canada.

出版信息

Can J Anaesth. 2019 Oct;66(10):1173-1183. doi: 10.1007/s12630-019-01411-x. Epub 2019 May 30.

Abstract

PURPOSE

We prospectively assessed inter-rater reliability of three physical function measures in Canadian intensive care unit (ICU) survivors in the inpatient setting.

METHODS

We enrolled patients who had an ICU length of stay of ≥ three days, were mechanically ventilated for ≥ 24 hr, and were ambulating independently before hospital admission. Weekly from ICU discharge to hospital discharge, two trained frontline clinicians, blinded to each other's findings, independently performed the Physical Function ICU Test-scored (PFIT-s; score out of 10), 30-sec sit-to-stand (30STS; # of stands), and two-minute walk test (2MWT; distance in m), all within 24 hr. We calculated the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC).

RESULTS

We enrolled 42 patients. PFIT-s: in 36 patients with 66 paired scores, the ICC was 0.78 (95% confidence interval [CI], 0.66 to 0.86), the SEM was 1.04, and the MDC was 2.42. 30STS: in 35 patients with 67 paired scores, the ICC was 0.85 (95% CI, 0.76 to 0.90), the SEM was 1.91, and the MDC was 4.45. 2MWT: in 35 patients with 58 paired scores, the ICC was 0.78 (95% CI, 0.66 to 0.87), the SEM was 20.87, and the MDC was 48.69.

CONCLUSION

These three measures show good inter-rater reliability when used by trained frontline clinicians to assess physical function in ICU survivors in the inpatient setting.

摘要

目的

我们前瞻性评估了三种身体功能测量方法在加拿大住院重症监护病房(ICU)幸存者中的组内可靠性。

方法

我们招募了 ICU 住院时间≥3 天、机械通气≥24 小时且入院前能独立行走的患者。从 ICU 出院到出院,每周由两名经过培训的一线临床医生进行评估,他们彼此之间的发现是盲态的,独立进行身体功能 ICU 测试评分(PFIT-s;满分 10 分)、30 秒坐站测试(30STS;站立次数)和 2 分钟步行测试(2MWT;距离 m),均在 24 小时内完成。我们计算了组内相关系数(ICC)、测量误差(SEM)和最小可检测变化(MDC)。

结果

我们共招募了 42 名患者。PFIT-s:在 36 名患者的 66 对评分中,ICC 为 0.78(95%置信区间 [CI],0.66 至 0.86),SEM 为 1.04,MDC 为 2.42。30STS:在 35 名患者的 67 对评分中,ICC 为 0.85(95% CI,0.76 至 0.90),SEM 为 1.91,MDC 为 4.45。2MWT:在 35 名患者的 58 对评分中,ICC 为 0.78(95% CI,0.66 至 0.87),SEM 为 20.87,MDC 为 48.69。

结论

当由经过培训的一线临床医生使用时,这三种测量方法在评估住院 ICU 幸存者的身体功能时具有良好的组内可靠性。

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