ArticleJournal of the American Geriatrics Society2023
Development and validation of a prediction model for persistent functional impairment among older ICU survivors.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Creation of a dedicated post-intensive care geriatric unit (PIGU), proof of concept and preliminary results.European geriatric medicine · 2026Article
- Improving long-term trajectories in very old survivors of intensive care: a narrative review.European geriatric medicine · 2026Review
- Predicting Post-ICU Functional Impairment During Early ICU Admission Using Real-world Electronic Health Record Data.Clinical nursing research · 2025Article
- Identifying distinct clusters of ICU survivors by integrating demographic, pre-admission quality of life, and clinical data: a large prospective cohort study.Intensive care medicine · 2025Article
- Risk prediction models for post-intensive care syndrome of ICU discharged patients: A systematic review.International journal of nursing sciences · 2025Review
- Feasibility of In-Hospital Administration of a Tool to Predict Persistent Post-ICU Functional Impairment Among Older ICU Survivors: A Pilot Study.CHEST critical care · 2024Article
- Prognosticating the outcome of intensive care in older patients-a narrative review.Annals of intensive care · 2024Review
- Development and validation of early prediction models for new-onset functional impairment in patients after being transferred from the ICU.Scientific reports · 2024Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundCritical illness often leads to persistent functional impairment among older Intensive Care Unit (ICU) survivors. Identification of high-risk survivors prior to discharge from their ICU hospitalization can facilitate targeting for restorative interventions after discharge, potentially improving the likelihood of functional recovery. Our objective was to develop and validate a prediction model for persistent functional impairment among older adults in the year after an ICU hospitalization.
methodsThe analytic sample included community-living participants enrolled in the National Health and Aging Trends Study 2011 cohort who survived an ICU hospitalization through December 2017 and had a follow-up interview within 1 year. Persistent functional impairment was defined as failure to recover to the pre-ICU level of function within 12 months of discharge from an ICU hospitalization. We used Bayesian model averaging to identify the final predictors from a comprehensive set of 17 factors. Discrimination and calibration were assessed using area-under-the-curve (AUC) and calibration plots.
resultsThe development cohort included 456 ICU admissions (2,654,685 survey-weighted admissions) and the validation cohort included 227 ICU admissions (1,350,082 survey-weighted admissions). In the development cohort, the median age was 81.0 years (interquartile range [IQR] 76.0, 86.0) and 231 (50.7%) participants were women; demographic characteristics were comparable in the validation cohort. The rates of persistent functional impairment were 49.3% (development) and 50.2% (validation). The final model included age, pre-ICU disability, probable dementia, frailty, prior hospitalizations, vision impairment, depressive symptoms, and hospital length of stay. The model demonstrated good discrimination (AUC 71%, 95% confidence interval [CI] 0.66-0.76) and good calibration. When applied to the validation cohort, the model demonstrated comparable discrimination (AUC 72%, 95% CI 0.66-0.78) and good calibration.
conclusionsApplication of the model prior to discharge from an ICU hospitalization may identify older adults at the highest risk of persistent functional impairment in the subsequent year, thereby facilitating targeted interventions and follow-up.
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