Annals of the American Thoracic Society · 2016
The ICU Mobility Scale Has Construct and Predictive Validity and Is Responsive. A Multicenter Observational Study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Tipping Claire J, Bailey Michael J, Bellomo Rinaldo, Berney Susan, Buhr Heidi, Denehy Linda, Harrold Meg, Holland Anne, Higgins Alisa M, Iwashyna Theodore J, Needham Dale, Presneill Jeff, Saxena Manoj, Skinner Elizabeth H, Webb Steve, Young Paul, Zanni Jennifer, Hodgson Carol L
Аннотация
RATIONALE: The ICU Mobility Scale (IMS) is a measure of mobility milestones in critically ill patients.
OBJECTIVES: This study aimed to determine the validity and responsiveness of the IMS from a prospective cohort study of adults admitted to the intensive care unit (ICU).
METHODS: Construct and predictive validity were assessed by comparing IMS values at ICU discharge in 192 patients to other variables using Spearman rank correlation coefficient, Mann-Whitney U tests, and logistic regression. Responsiveness was assessed using change over time, effect size, floor and ceiling effects, and percentage of patients showing change.
MEASUREMENTS AND MAIN RESULTS: The IMS at ICU discharge demonstrated a moderate correlation with muscle strength (r = 0.64, P < 0.001). There was a significant difference between the IMS at ICU discharge in patients with ICU-acquired weakness (median, 4.0; interquartile range, 3.0-5.0) compared with patients without (median, 8.0; interquartile range, 5.0-8.0; P < 0.001). Increasing IMS values at ICU discharge were associated with survival to 90 days (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.14-1.66) and discharge home (OR, 1.16; 95% CI, 1.02-1.32) but not with return to work at 6 months (OR, 1.09; 95% CI, 0.92-1.28). The IMS was responsive with a significant change from study enrollment to ICU discharge (d = 0.8, P < 0.001), with IMS values increasing in 86% of survivors during ICU admission. No substantial floor (14% scored 0) or ceiling (4% scored 10) effects were present at ICU discharge.
CONCLUSIONS: Our findings support the validity and responsiveness of the IMS as a measure of mobility in the ICU.
OBJECTIVES: This study aimed to determine the validity and responsiveness of the IMS from a prospective cohort study of adults admitted to the intensive care unit (ICU).
METHODS: Construct and predictive validity were assessed by comparing IMS values at ICU discharge in 192 patients to other variables using Spearman rank correlation coefficient, Mann-Whitney U tests, and logistic regression. Responsiveness was assessed using change over time, effect size, floor and ceiling effects, and percentage of patients showing change.
MEASUREMENTS AND MAIN RESULTS: The IMS at ICU discharge demonstrated a moderate correlation with muscle strength (r = 0.64, P < 0.001). There was a significant difference between the IMS at ICU discharge in patients with ICU-acquired weakness (median, 4.0; interquartile range, 3.0-5.0) compared with patients without (median, 8.0; interquartile range, 5.0-8.0; P < 0.001). Increasing IMS values at ICU discharge were associated with survival to 90 days (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.14-1.66) and discharge home (OR, 1.16; 95% CI, 1.02-1.32) but not with return to work at 6 months (OR, 1.09; 95% CI, 0.92-1.28). The IMS was responsive with a significant change from study enrollment to ICU discharge (d = 0.8, P < 0.001), with IMS values increasing in 86% of survivors during ICU admission. No substantial floor (14% scored 0) or ceiling (4% scored 10) effects were present at ICU discharge.
CONCLUSIONS: Our findings support the validity and responsiveness of the IMS as a measure of mobility in the ICU.