Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, 3004, Australia; Department of Physiotherapy, Monash Health, Clayton, VIC, 3168, Australia.
College of Health and Biomedicine, Victoria University, Footscray, VIC, 3011, Australia.
Aust Crit Care. 2023 Jul;36(4):485-491. doi: 10.1016/j.aucc.2022.05.006. Epub 2022 Jul 7.
Establishing sequela following critical illness is a public health priority; however, recruitment and retention of this cohort make assessing functional outcomes difficult. Completing patient-reported outcome measures (PROMs) via telephone may improve participant and researcher involvement; however, there is little evidence regarding the correlation of PROMs to performance-based outcome measures in critical care survivors.
The objective of this study was to assess the relationship between self-reported and performance-based measures of function in survivors of critical illness.
This was a nested cohort study of patients enrolled within a previously published study determining predictors of disability-free survival. Spearman's correlation (r) was calculated between four performance-based outcomes (the Functional Independence Measure [FIM], 6-min walk distance [6MWD], Functional Reach Test [FRT], and grip strength) that were collected during a home visit 6 months following their intensive care unit admission, with two commonly used PROMs (World Health Organization Disability Assessment Scale 2.0 12 Level [WHODAS 2.0] and EuroQol-5 Dimension-5 Level [EQ-5D-5L]) obtained via phone interview (via the PREDICT study) at the same time point.
There were 38 PROMs obtained from 40 recruited patients (mean age = 59.8 ± 16 yrs, M:F = 24:16). All 40 completed the FIM and grip strength, 37 the 6MWD, and 39 the FRT. A strong correlation was found between the primary outcome of the WHODAS 2.0 with all performance-based outcomes apart from grip strength where a moderate correlation was identified. Although strong correlations were also established between the EQ-5D-5L utility score and the FIM, 6MWD, and FRT, it only correlated weakly with grip strength. The EQ-5D overall global health rating only had very weak to moderate correlations with the performance-based outcomes.
The WHODAS 2.0 correlated stronger across multiple performance-based outcome measures of functional recovery and is recommended for use in survivors of critical illness.
确定危重病患者的后遗症是公共卫生的重点，但招募和保留这一队列使得评估功能结果变得困难。通过电话完成患者报告的结果测量（PROM）可能会提高参与者和研究人员的参与度；然而，关于危重病幸存者的 PROM 与基于表现的结果测量之间的相关性的证据很少。
本研究旨在评估危重病幸存者自我报告和基于表现的功能测量之间的关系。
这是一项嵌套队列研究，纳入了先前发表的一项研究中的患者，该研究确定了无残疾生存的预测因素。在入住重症监护病房 6 个月后进行家庭访视时，通过 Spearman 相关系数（r）计算了四个基于表现的结果（功能性独立测量[FIM]、6 分钟步行距离[6MWD]、功能性伸手测试[FRT]和握力）与两个常用的 PROM（世界卫生组织残疾评估量表 2.0 12 级[WHODAS 2.0]和欧洲五维健康量表 5 级[EQ-5D-5L]）之间的关系，这些 PROM 通过电话访谈（通过 PREDICT 研究）在同一时间点获得。
从 40 名招募的患者中获得了 38 份 PROM（平均年龄 59.8±16 岁，M:F=24:16）。所有 40 名患者均完成了 FIM 和握力测试，37 名患者完成了 6MWD 测试，39 名患者完成了 FRT 测试。除了握力测试外，WHODAS 2.0 与所有基于表现的结果之间都存在很强的相关性，而握力测试则存在中度相关性。虽然 EQ-5D-5L 效用评分与 FIM、6MWD 和 FRT 之间也建立了很强的相关性，但与握力测试的相关性较弱。EQ-5D 总体健康评分与基于表现的结果仅存在弱到中度的相关性。
WHODAS 2.0 与多个基于表现的功能恢复结果测量的相关性更强，建议在危重病幸存者中使用。
