Table 3.

Characteristics associated with disability and/or death in older ICU survivors

Characteristic or Exposure	Measurement	Comment	Supporting Studies
Age		Independent predictor in more recent larger cohort studies, but not in older smaller cohort studies	10–14
Pre-Existing Disability	Admission from skilled-care facility, Katz ADLs, Barthel Index	Pre-hospitalization estimates of disability using more detailed surveys than the Katz ADLs need validation (e.g. Barthel Index).	4, 19, 20, 28, 58
Pre-Existing Frailty	CFS	Subjective measure that quickly identifies at risk patients	67
Severe Sepsis		Persistent physical disability and neurocognitive impairment for up to 8 years after treatment of the initial infection	36
Medical or Unplanned Surgical ICU Admission			13
Use of Mechanical Ventilation			5, 16
Chronic Critical Illness	PMV via tracheostomy ≥ 10 days	Highest reported mortality among older ICU survivors	16, 24
Burden of Comorbidity	High Charlson Comorbidity Score		14, 19
DNR Preference	DNR order at hospital discharge	DNR decision reflects a patient preference, and may also reflect a severity of chronic illness and frailty not captured with other measurements	19
Disability at Hospital Discharge	Discharge to skilled-care facility, Katz ADLs, Barthel Index	Less disability is predictive of full-functional recovery among 1-year older ICU survivors (23)	5, 16, 19, 23, 28
Frailty at Hospital Discharge	CFS or Fried’s Index	Fried’s frailty measurements identify deficits that may be targets for post-ICU interventions	19, 68

ADL: Activities of Daily Living; CFS: Clinical Frailty Scale; PMV: Prolonged Mechanical Ventilation; DNR: Do-Not-Resuscitate