Schandl et al developed an instrument for predicting new-onset physical disability in an adult who has been admitted to the intensive care unit (ICU). This can help to identify a patient who may benefit from more aggressive management. The authors are from Karolinska University Hospital in Stockholm.
Patient selection: adult (mean age in 50’s) admitted to the ICU
Outcome: new-onset disability at 2 months after ICU stay (defined as either greater dependency in activities of daily living compared to functional status before ICU stay or on sick leave for physical reasons from work).
Parameters:
(1) education level
(2) core stability (able to sit without support in the ICU)
(3) fractures
(4) length of ICU stay
|
Parameter |
Finding |
Points |
|
education level |
<= elementary school |
57 |
|
|
high school or above |
0 |
|
ability to sit without support |
yes |
0 |
|
|
no |
45 |
|
fractures |
no |
0 |
|
|
yes |
45 |
|
length of ICU stay |
<= 2 days |
0 |
|
|
> 2 days |
30 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 177
• The higher the score the greater the risk for new-onset disability.
|
Score (All Combinations) |
Percentage with Disability |
|
0 |
16% |
|
30 |
36% |
|
45 |
47% |
|
57 |
59% |
|
75 |
70% |
|
87 |
80% |
|
90 |
80% |
|
120 |
94% |
|
132 |
96% |
|
147 |
98% |
|
177 |
99.5% |
Performance:
• The area under the ROC curve is 82%.
Purpose: To identify an adult in the ICU who may have new-onset physical disability at 2 months after discharge using the score of Schandl et al.
Specialty: Sports Medicine & Rehabilitation
Objective: severity, prognosis, stage, disability and performance
ICD-10: ,
