Factors associated with functional recovery after intensive care unit discharge in patients with mechanical ventilation: A multi-centre prospective observational study

Abstract

Objective

The rehabilitation of patients with disabilities post-intensive care unit (ICU) discharge is gaining importance and we aimed to identify factors associated with recovery in this study.

Design

This study was a secondary analysis of a multi-centre cohort study.

Setting

Nine centres in Japan.

Participants

A total of 121 patients admitted to the ICU who used an invasive ventilator for >48 h were the participants of this study.

Main measures

The relative functional gain and rehabilitation efficiency index, based on the Barthel Index, were calculated from the time of ICU discharge to hospital discharge. Factors related to the relative functional gain and rehabilitation efficiency index were analysed using multiple regression analysis.

Results

The median relative functional gain value was 85% and the median rehabilitation efficiency index value was 1.61 points/day. Multiple regression analysis showed that relative functional gain was significantly associated with ventilator duration (β = −1.420, p < 0.001), the Medical Research Council score at ICU discharge (β = 1.557, p < 0.001), the Barthel Index at ICU discharge (β = 0.501, p < 0.001) and rehabilitation hours in general wards (β = 0.591, p = 0.008). The rehabilitation efficiency index was significantly associated with ventilator duration (β = −0.089, p = 0.022) and Medical Research Council score at ICU discharge (β = 0.098, p < 0.001).

Conclusions

Our findings highlight the importance of post-ICU rehabilitation, particularly in patients with prolonged ventilation or reduced muscle strength, and support the clinical utility of rehabilitation impact indices in monitoring recovery trajectories.