Physical Function Scores at ICU Discharge Predict Post-Sepsis Disability and Mortality: Study
Karnataka to Improve Rural ICU Care with New Specialist Doctor Posts
Researchers have found in a new study that physical assessments at ICU discharge, particularly the Barthel Index, Medical Research Council (MRC) score, and handgrip strength, independently predicted 1-year physical dysfunction or death in sepsis survivors, with the Barthel Index showing the strongest predictive performance. Barthel Index and handgrip strength were also associated with later cognitive impairment. The study was published in the Journal of Intensive Care Medicine by Shinichi W. and colleagues.
The study focused on the predictive value of physical assessments conducted at ICU discharge. Participants had a median age of 74 years, reflecting a population that is highly vulnerable to post-ICU disability. Evaluated measures included the MRC score, which is a marker of global muscle strength; handgrip strength; and the Barthel index, a measure of activities of daily living. The primary outcome was defined as either physical functional disability-represented by a Barthel index ≤90-or death at 3, 6, and 12 months after discharge. Advanced statistical models were used to quantify predictive strength, including multiple logistic regression and area under the curve analysis.
Key Findings
The MRC score was an independent predictor of disability or death (OR = 0.98, 95% CI: 0.96–0.99; cut-off value 46).
Handgrip strength independently predicted the outcomes, with OR = 0.95, 95% CI: 0.92–0.98; cut-off value 12.0 kg.
The Barthel index at discharge predicted disability or death with an OR = 0.96 (95% CI: 0.95–0.98; cut-off value 15), and had the highest AUC at 0.718 for 12-month outcomes.
All three measures predicted outcomes at 3, 6, and 12 months.
The Barthel Index and handgrip strength were both associated with subsequent cognitive dysfunction and mental health disorders.
This multicenter cohort study demonstrated that physical and muscle strength assessments easily available at ICU discharge were significantly associated with the risk of physical functional disability or death during the first year after hospital discharge.
Reference:
Watanabe S, Morita Y, Nakamura K, et al. Prediction Capability of Physical Assessment at Intensive Care Unit Discharge for Long-Term Functional Outcomes in Patients with Sepsis. Journal of Intensive Care Medicine. 2025;0(0). doi:10.1177/08850666251383483
