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. 2019 Dec 6;1(12):e0066.
doi: 10.1097/CCE.0000000000000066. eCollection 2019 Dec.

Clinical Frailty Scale Score Before ICU Admission Is Associated With Mobility Disability in Septic Patients Receiving Early Rehabilitation

Hiroki Nakajima  1 , Mitsuaki Nishikimi  2 , Miho Shimizu  1 , Kazuhiro Hayashi  3 , Takayuki Inoue  1 , Kazuki Nishida  4 , Kunihiko Takahashi  4 , Shigeyuki Matsui  4 , Yoshihiro Nishida  1 , Naoyuki Matsuda  2
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Clinical Frailty Scale Score Before ICU Admission Is Associated With Mobility Disability in Septic Patients Receiving Early Rehabilitation

Hiroki Nakajima et al. Crit Care Explor. .

Abstract

To clarify the relationship between mobility disability at the time of discharge from the ICU and clinical factors evaluated at ICU admission in septic patients.

Design: A single-center, retrospective, observational study.

Setting: Ten-bed, the emergency and medical ICU.

Patients: We analyzed the data of septic patients who were admitted to our ICU between September 2012 and September 2016 and received early rehabilitation.

Interventions: None.

Measurements and main results: The patients were categorized into two groups based on their scores on the ICU mobility scale at the time of discharge from the ICU: the mobility disability group (ICU mobility scale score < 9) and the no mobility disability group (ICU mobility scale score ≥ 9). Of the 110 eligible patients, 63 met the inclusion criteria; of these, 46 patients (73%) were classified into the mobility disability group, and 17 patients (27%) were classified into the no mobility disability group. The age (median, 72 vs 64 yr; p = 0.024), prevalence of patients with clinical frailty scale scores of greater than or equal to 5 (54% vs 12%; p = 0.003), Sequential Organ Failure Assessment score (median, 9.0 vs 6.0; p = 0.006) and rate of vasopressin use (26% vs 0%; p = 0.026) were significantly higher in the mobility disability group as compared with the no mobility disability group. Among the candidate variables for which values recorded before/at the time of ICU admission were available, the clinical frailty scale score was identified as the only independent, statistically significant predictor of mobility disability at ICU discharge (odds ratio, 7.77; 95% CI, 1.37-44.21; p = 0.021). The positive predictive value and negative predictive value of clinical frailty scale scores greater than or equal to 5 for mobility disability at ICU discharge were 92.6% and 41.7%, respectively.

Conclusions: The clinical frailty scale score was associated with increased mobility disability at ICU discharge in septic patients receiving early rehabilitation.

Keywords: clinical frailty scale; early rehabilitation; functional prognosis; intensive care unit mobility scale; mobility disability; sepsis.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Patients’ flow in this study.
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