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- Title
Assessing functional status after intensive care unit stay: the Barthel Index and the Katz Index.
- Authors
DA SILVEIRA, LEDA TOMIKO YAMADA; DA SILVA, JANETE MARIA; PAVAN SOLER, JÚLIA MARIA; YEA LING SUN, CAROLINA; TANAKA, CLARICE; FU, CAROLINA; Silveira, Leda Tomiko Yamada da; Silva, Janete Maria da; Soler, Júlia Maria Pavan; Sun, Carolina Yea Ling
- Abstract
<bold>Objective: </bold>To assess the functional status of post-ICU patients using the Barthel Index (BI) and the Katz Index (KI) and to assess which is more suitable for this population.<bold>Design: </bold>Retrospective longitudinal study.<bold>Setting: </bold>Public tertiary hospital in São Paulo (Brazil).<bold>Participants: </bold>Patients aged ≥18 years old, admitted to ICU, who were treated with mechanical ventilation (MV) ≥ 24 h and were discharged to ward.<bold>Exclusion Criteria: </bold>Inability to answer the BI and the KI; limiting neurological or orthopaedic conditions; ICU stay ≥90 days. Patients transferred to or from other hospitals or who died in the wards were not analysed.<bold>Intervention: </bold>BI and KI were scored pre-ICU and post-ICU and the variation was calculated.<bold>Main Outcome Measures: </bold>BI and KI scores were compared using analysis based on item response theory (IRT), using degree of difficulty and discriminating items as parameters.<bold>Results: </bold>Median age was 52 years old, median APACHE II score was 15. Median ICU stay was 11 days and median MV duration was 4 days. BI variation was 44% and KI variation was 55%. In IRT analysis, BI considered a larger number of items with different levels of difficulty.<bold>Conclusion: </bold>Both the BI and the KI revealed significant deterioration of functional status after ICU discharge. The IRT analysis suggested that the Barthel Index might be a better scale than the Katz Index for the assessment of functional status of patients discharged from ICU, since it presented better discrimination of the ability to carry out the tasks.
- Subjects
BRAZIL; INTENSIVE care patients; BARTHEL Index; MEDICAL needs assessment; HOSPITAL admission &; discharge; INTENSIVE care units; HEALTH outcome assessment; APACHE (Disease classification system); ARTIFICIAL respiration; LENGTH of stay in hospitals; LONGITUDINAL method; QUESTIONNAIRES; ACTIVITIES of daily living; SPECIALTY hospitals; RETROSPECTIVE studies
- Publication
International Journal for Quality in Health Care, 2018, Vol 30, Issue 4, p265
- ISSN
1353-4505
- Publication type
journal article
- DOI
10.1093/intqhc/mzx203