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Early identification of patients at risk of long-term critical illness-associated physical disability: is it possible?

ICU-acquired weakness can hinder and determine the course of recovery from critical illness, leading to life-changing disability. Risk factors include multiorgan failure and prolonged bed rest; however, no prognostic model or screening tool for new-onset disability has been established to date. With...

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Detalles Bibliográficos
Autores principales: Corner, Evelyn J, Brett, Stephen J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4331459/
https://www.ncbi.nlm.nih.gov/pubmed/25672518
http://dx.doi.org/10.1186/s13054-014-0629-3
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author Corner, Evelyn J
Brett, Stephen J
author_facet Corner, Evelyn J
Brett, Stephen J
author_sort Corner, Evelyn J
collection PubMed
description ICU-acquired weakness can hinder and determine the course of recovery from critical illness, leading to life-changing disability. Risk factors include multiorgan failure and prolonged bed rest; however, no prognostic model or screening tool for new-onset disability has been established to date. With no way of targeting the at-risk population, it is difficult to demonstrate the benefit of rehabilitation interventions in research and prioritize resources clinically. In a recent issue of Critical Care, Schandl and colleagues aimed to establish a predictive screening tool for new-onset disability using 23 possible predictors. They found that using the following risk factors – low educational level, fractures, reduced core stability and length of ICU stay over 2 days – they were able to develop a risk score predictive of disability at 2 months after hospital discharge. These investigators propose that this will help to identify patients requiring follow-up and may increase the power to detect change in interventional studies. Whilst this is promising work, further validation is essential: firstly, to make it a clinically workable tool in terms of appropriate ‘cut offs’; secondly, to ensure that it is transferable in different socio-economic environments; and finally, to make sure that those identified as ‘at risk’ are those that would benefit the most from targeted intervention.
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spelling pubmed-43314592015-02-19 Early identification of patients at risk of long-term critical illness-associated physical disability: is it possible? Corner, Evelyn J Brett, Stephen J Crit Care Commentary ICU-acquired weakness can hinder and determine the course of recovery from critical illness, leading to life-changing disability. Risk factors include multiorgan failure and prolonged bed rest; however, no prognostic model or screening tool for new-onset disability has been established to date. With no way of targeting the at-risk population, it is difficult to demonstrate the benefit of rehabilitation interventions in research and prioritize resources clinically. In a recent issue of Critical Care, Schandl and colleagues aimed to establish a predictive screening tool for new-onset disability using 23 possible predictors. They found that using the following risk factors – low educational level, fractures, reduced core stability and length of ICU stay over 2 days – they were able to develop a risk score predictive of disability at 2 months after hospital discharge. These investigators propose that this will help to identify patients requiring follow-up and may increase the power to detect change in interventional studies. Whilst this is promising work, further validation is essential: firstly, to make it a clinically workable tool in terms of appropriate ‘cut offs’; secondly, to ensure that it is transferable in different socio-economic environments; and finally, to make sure that those identified as ‘at risk’ are those that would benefit the most from targeted intervention. BioMed Central 2014-11-19 2014 /pmc/articles/PMC4331459/ /pubmed/25672518 http://dx.doi.org/10.1186/s13054-014-0629-3 Text en © Corner and Brett; licensee BioMed Central Ltd. 2014 The licensee has exclusive rights to distribute this article, in any medium, for 12 months following its publication. After this time, the article is available under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Commentary
Corner, Evelyn J
Brett, Stephen J
Early identification of patients at risk of long-term critical illness-associated physical disability: is it possible?
title Early identification of patients at risk of long-term critical illness-associated physical disability: is it possible?
title_full Early identification of patients at risk of long-term critical illness-associated physical disability: is it possible?
title_fullStr Early identification of patients at risk of long-term critical illness-associated physical disability: is it possible?
title_full_unstemmed Early identification of patients at risk of long-term critical illness-associated physical disability: is it possible?
title_short Early identification of patients at risk of long-term critical illness-associated physical disability: is it possible?
title_sort early identification of patients at risk of long-term critical illness-associated physical disability: is it possible?
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4331459/
https://www.ncbi.nlm.nih.gov/pubmed/25672518
http://dx.doi.org/10.1186/s13054-014-0629-3
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