Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan;43(1):39-47.
doi: 10.1007/s00134-016-4563-5. Epub 2016 Sep 29.

The effects of performance status one week before hospital admission on the outcomes of critically ill patients

Fernando G Zampieri  1   2 , Fernando A Bozza  3   4 , Giulliana M Moralez  3   5 , Débora D S Mazza  6 , Alexandre V Scotti  7 , Marcelo S Santino  8 , Rubens A B Ribeiro  9 , Edison M Rodrigues Filho  10 , Maurício M Cabral  11 , Marcelo O Maia  12 , Patrícia S D'Alessandro  13 , Sandro V Oliveira  14 , Márcia A M Menezes  15 , Eliana B Caser  16 , Roberto S Lannes  17 , Meton S Alencar Neto  18 , Maristela M Machado  19 , Marcelo F Sousa  20 , Jorge I F Salluh  3   21 , Marcio Soares  22   23
Affiliations

The effects of performance status one week before hospital admission on the outcomes of critically ill patients

Fernando G Zampieri et al. Intensive Care Med. 2017 Jan.

Abstract

Purpose: To assess the impact of performance status (PS) impairment 1 week before hospital admission on the outcomes in patients admitted to intensive care units (ICU).

Methods: Retrospective cohort study in 59,693 patients (medical admissions, 67 %) admitted to 78 ICUs during 2013. We classified PS impairment according to the Eastern Cooperative Oncology Group (ECOG) scale in absent/minor (PS = 0-1), moderate (PS = 2) or severe (PS = 3-4). We used univariate and multivariate logistic regression analyses to investigate the association between PS impairment and hospital mortality.

Results: PS impairment was moderate in 17.3 % and severe in 6.9 % of patients. The hospital mortality was 14.4 %. Overall, the worse the PS, the higher the ICU and hospital mortality and length of stay. In addition, patients with worse PS were less frequently discharged home. PS impairment was associated with worse outcomes in all SAPS 3, Charlson Comorbidity Index and age quartiles as well as according to the admission type. Adjusting for other relevant clinical characteristics, PS impairment was associated with higher hospital mortality (odds-ratio (OR) = 1.96 (95 % CI 1.63-2.35), for moderate and OR = 4.22 (3.32-5.35), for severe impairment). The effects of PS on the outcome were particularly relevant in the medium range of severity-of-illness. These results were consistent in the subgroup analyses. However, adding PS impairment to the SAPS 3 score improved only slightly its discriminative capability.

Conclusion: PS impairment was associated with worse outcomes independently of other markers of chronic health status, particularly for patients in the medium range of severity of illness.

Keywords: Critical care; Markers of baseline health status; Outcomes; Performance status.

PubMed Disclaimer

Comment in

References

    1. Ann Oncol. 2014 Sep;25(9):1829-35 - PubMed
    1. Circulation. 2007 Feb 20;115(7):928-35 - PubMed
    1. Epidemiology. 2014 Jan;25(1):114-21 - PubMed
    1. BMC Med Res Methodol. 2011 Jan 28;11:13 - PubMed
    1. Epidemiology. 2010 Jan;21(1):128-38 - PubMed

LinkOut - more resources