Determination of functional prognosis in hospitalized patients following an intensive care admission

Table 1 Subjects characteristics (n = 198)

Variables	Levels	Age < 65 yr	Age≥65 yr	P value	All sample
		Mean ± SD	Mean ± SD		Mean ± SD	Median (Min; max)
		n = 39	n = 159		n = 198
Age, yr		50.5 ± 12.2	82.7 ± 8.6	NT	76.4 ± 15.9	80 (24; 101)
KATZ at ICU admission, score		3.9 ± 1.4	4.3 ± 1.4	0.207	4.2 ± 1.4	4 (0; 6)
MRC at ICU admission, score		46.6 ± 15.1	39.1 ± 14.9	0.007	40.6 ± 15.2	44 (0; 60)
KATZ at ward admission, score		2.7 ± 2.1	4.2 ± 1.6	< 0.001	3.9 ± 1.8	4 (0; 6)
MRC at ward admission, score		48.1 ± 15.0	40.0 ± 15.1	0.004	41.6 ± 15.3	45.5 (0; 60)
KATZ at hospital discharge, score		2.5 ± 2.2	4.0 ± 1.8	< 0.001	3.7 ± 2	4 (0; 6)
MRC at hospital discharge, score		50.6 ± 15.4	41.9 ± 14.0	0.002	43.6 ± 14.7	48 (0; 60)
Hospital length of stay, d		9.9 ± 7.0	12.1 ± 9.8	0.117	12 ± 9	9 (2; 52)
SAPS3, %		43.8 ± 8.8	53.7 ± 8.6	< 0.001	51.7 ± 9.5	51 (27; 89)
Gender, n (%)	Female	17 (14)	104 (86)	0.017	121 (61)	-
	Male	22 (29)	55 (71)	-	77 (39)	-
Sepsis, n (%)	No	19 (20)	74 (80)	0.859	93 (47)	-
	Yes	20 (19)	85 (81)	-	105 (53)	-
COPD, n (%)	No	37 (21)	142 (79)	0.377	179 (90)	-
	Yes	2 (11)	17 (89)	-	19 (10)	-
Dementia, n (%)	No	39 (27)	108 (73)	< 0.001	147 (74)	-
	Yes	0 (0)	51 (100)	-	51 (26)	-
Previous stroke, n (%)	No	38 (22)	134 (78)	0.032	172 (87)	-
	Yes	1 (4)	25 (96)	-	26 (13)	-
Cause of ICU admission, n (%)	Cardiovascular	4 (33)	8 (67)	0.646	12 (6)	-
	Gastrointestinal	3 (16)	16 (84)	-	19 (10)	-
	Neoplastic	0 (0)	1 (100)	-	1 (1)	-
	Neurologic	4 (25)	12 (75)	-	16 (8)	-
	Renal	8 (23)	27 (77)	-	35 (18)	-
	Pulmonary	16 (21)	62 (79)	-	78 (39)	-
	Others	4 (11)	33 (89)	-	37 (19)	-

KATZ: KATZ Index of Independence in Activities of Daily Living; MRC: Medical Research Council; SAPS3: Simplified acute physiology score; COPD: Chronic obstructive pulmonary disease; NT: Not tested.

Table 2 Generalized linear model results for functional outcomes (n = 198)

Functional outcome		ΔKATZ					ΔMRC
		Test for model effects		Parameter estimates			Test for model effects		Parameter estimates
Comparison	Variable	Waldχ2	P (Sig.)	B	Lower 95%CI	Upper 95%CI	Waldχ2	P (Sig.)	B	Lower 95%CI
ICU	Age, yr	10.006	0.002	0.043	0.016	0.069	1.430	0.232	0.016	-0.010
	SAPS3, %	1.312	0.252	-0.023	-0.063	0.017	5.789	0.016	-0.053	-0.097
	Length of stay in ICU, d	1.295	0.255	-0.040	-0.110	0.029	3.145	0.076	-0.068	-0.144
	KATZ at ICU admission, score	7.385	0.007	-0.562	-0.967	-0.157	0.399	0.528	0.119	-0.251
	MRC at ICU admission, score	4.837	0.028	-0.045	-0.084	-0.005	9.645	0.002	0.057	0.021
	Sex (male = 1)	0.069	0.792	-0.108	-0.913	0.697	0.733	0.392	0.341	-0.440
	Sepsis (no)	0.105	0.745	-0.133	-0.934	0.669	0.088	0.766	-0.122	-0.924
	COPD (no)	0.184	0.668	-0.302	-1.683	1.078	0.479	0.489	-0.488	-1.870
	Dementia (no)	0.238	0.626	-0.261	-1.312	0.789	1.478	0.224	-0.622	-1.626
	Previous stroke (no)	4.671	0.031	-1.782	-3.398	-0.166	8.815	0.003	-2.667	-4.428
	Cause of ICU admission	3.785	0.706	NS	NS	NS	7.956	0.241	NS	NS
Ward	Age, yr	6.520	0.011	0.040	0.009	0.071	1.235	0.267	0.016	-0.012
	SAPS3, %	0.137	0.711	0.008	-0.034	0.050	0.029	0.865	-0.004	-0.046
	Length of stay in ward, d	2.726	0.099	-0.047	-0.102	0.009	1.014	0.314	-0.028	-0.083
	KATZ at ICU admission, score	9.241	0.002	-0.858	-1.411	-0.305	1.185	0.276	0.228	-0.183
	MRC at ICU admission, score	1.339	0.247	0.034	-0.024	0.092	20.013	< 0.001	0.223	0.125
	KATZ at ward admission, score	12.782	< 0.001	0.867	0.392	1.342	0.503	0.478	0.123	-0.217
	MRC at ward admission, score	4.418	0.036	-0.064	-0.123	-0.004	12.085	0.001	-0.170	-0.265
	Sex (male = 1)	0.548	0.459	0.306	-0.504	1.115	0.971	0.324	-0.361	-1.079
	Sepsis (no)	4.528	0.033	0.940	0.074	1.805	0.740	0.390	0.332	-0.424
	COPD (no)	0.035	0.852	-0.122	-1.404	1.160	1.978	0.160	0.881	-0.347
	Dementia (no)	0.138	0.710	-0.206	-1.290	0.879	0.063	0.803	0.120	-0.822
	Previous stroke (no)	0.362	0.548	-0.377	-1.606	0.852	0.067	0.796	-0.144	-1.231
	Cause of ICU admission	6.186	0.403	NS	NS	NS	4.222	0.647	NS	NS
Total	Age, yr	8.077	0.004	1.465	-3.56	6.490	0.243	0.622	0.007	-0.019
	SAPS3, %	0.816	0.366	0.044	0.014	0.075	0.832	0.362	0.019	-0.021
	Total length of stay, d	6.629	0.010	-0.021	-0.066	0.024	4.799	0.028	-0.039	-0.075
	KATZ at ICU admission, score	10.269	0.001	-0.056	-0.098	-0.013	0.024	0.876	-0.031	-0.424
	MRC at ICU admission, score	0.257	0.612	0.826	0.321	1.331	1.077	0.299	-0.024	-0.069
	KATZ at ward admission, score	10.099	0.001	0.014	-0.040	0.069	0.006	0.937	-0.014	-0.364
	MRC at ward admission, score	2.743	0.098	-0.752	-1.215	-0.288	4.406	0.036	0.049	0.003
	Sex (male = 1)	0.157	0.692	-0.047	-0.102	0.009	3.864	0.049	-0.751	-1.499
	Sepsis (no)	1.589	0.208	0.169	-0.668	1.007	0.439	0.508	0.247	-0.484
	COPD (no)	0.002	0.968	0.594	-0.330	1.517	1.076	0.300	0.570	-0.507
	Dementia (no)	0.028	0.866	-0.026	-1.318	1.265	0.629	0.428	-0.363	-1.261
	Previous stroke (no)	0.046	0.831	-0.097	-1.226	1.032	3.273	0.070	0.911	-0.076
	Cause of ICU admission	12.048	0.061	NS	NS	NS	2.985	0.811	NS	NS

KATZ: KATZ Index of Independence in Activities of Daily Living; SAPS3: Simplified acute physiology score; MRC: Medical Research Council; COPD: Chronic obstructive pulmonary disease; NS: No significant; A: Significant differences for categories cardiovascular and respiratory; B: Significant differences for categories gastrointestinal and respiratory.

Table 3 Receiver-operating characteristic curve analysis for significant factors for predicting functional outcomes

Functional outcomes		ΔKATZ					ΔMRC
		AUC	Cut-off	Sensitivity	Specificity	P (Sig.)	AUC	Cut-off	Sensitivity	Specificity	P (Sig.)
ICU	Age, yr	0.664	78.5	41%	42%	0.001	1	1	1	1	1
	SAPS3, %	1	1	1	1	1	0.661	50.5	68%	52%	0.014
	KATZ at ICU admission, score	0.515	4.5	47%	58%	0.753	1	1	1	1	1
	MRC at ICU admission, score	0.592	45.5	57%	56%	0.053	0.653	37	44%	35%	0.001
Ward	Age, yr	0.712	81.5	32%	47%	< 0.001	1	1	1	1	1
	KATZ at ICU admission, score	0.590	4.5	35%	52%	0.035	1	1	1	1	1
	MRC at ICU admission, score	1	1	1	1	1	0.681	44.5	39%	42%	< 0.001
	KATZ at ward admission, score	0.746	2.5	63%	12%	< 0.001	1	1	1	1	1
	MRC at ward admission, score	0.721	47	69%	67%	< 0.001	0.553	43.3	54%	48%	0.200
Total	Age, yr	0.592	81.5	38%	52%	0.058	1	1	1	1	1
	Total length of stay, d	0.617	11.5	51%	72%	0.016	0.649	10.5	54%	73%	0.001
	KATZ at ICU admission, score	0.621	3.5	53%	28%	0.012	1	1	1	1	1
	KATZ at ward admission, score	0.515	4.5	38%	58%	0.750	1	1	1	1	1
	MRC at ward admission, score	1	1	1	1	1	0.696	37	51%	35%	< 0.001

¹Variables with no significant effect on the generalized linear model were not analyzed using ROC curves. KATZ: KATZ Index of Independence in Activities of Daily Living; MRC: Medical Research Council; SAPS3: Simplified acute physiology score; AUC: Area under the curve.