Factors associated with functional independence at hospital discharge and 6 months post-hospitalization in intensive care unit survivors with cancer: A prospective cohort study.

Abstract

Purpose: Analyze the factors associated with functional independence in cancer patients discharged from the intensive care unit (ICU).

Methods: This is a prospective cohort study that included cancer patients discharged from the ICU of a tertiary oncology unit between March 2023 and March 2024. The Barthel Index (BI), Medical Research Council (MRC) score, Handgrip Strength (HS), ICU Mobility Scale (IMS), and 30-s Chair Stand Test (CS-30) were used to evaluate the physical and functional capacity of the patients at 3 times points: ICU discharge, hospital discharge, and 6 months post-hospitalization. Logistic regression was used to identify factors associated with the presence of functional independence at hospital discharge and at 6-month post-hospitalization.

Results: In total, 62 patients with a median age of 64 (51-72) years were included. The most common primary tumor site was the digestive system (41.9%) and 6 (9.7%) patients returned to work. Multivariate analysis revealed that higher MRC scores at ICU discharge (OR 1.08; 95% CI 1.01-1.16; p = 0.013) increased the odds of achieving functional independence at hospital discharge and higher IMS scores at hospital discharge (OR 1.41; 95% CI 1.06-1.88; p = 0.017) increased the odds of achieving functional independence at 6 months post-hospitalization.

Conclusion: Cancer survivors of critical illness show improvements in physical capacity over time. Muscle strength at ICU discharge and level of mobility at hospital discharge are independent predictors of functional independence at hospital discharge and 6 months post-hospitalization, respectively.