• Margaret S Herridge, Leslie M Chu, Andrea Matte, George Tomlinson, Linda Chan, Claire Thomas, Jan O Friedrich, Sangeeta Mehta, Francois Lamontagne, Melanie Levasseur, Niall D Ferguson, Neill K J Adhikari, Jill C Rudkowski, Hilary Meggison, Yoanna Skrobik, John Flannery, Mark Bayley, Jane Batt, Santos Claudia Dos CD 3 Interdepartmental Division of Critical Care Medicine. 9 Department of Medicine. , Susan E Abbey, Adrienne Tan, Vincent Lo, Sunita Mathur, Matteo Parotto, Denise Morris, Linda Flockhart, Eddy Fan, Christie M Lee, M Elizabeth Wilcox, Najib Ayas, Karen Choong, Robert Fowler, Damon C Scales, Tasnim Sinuff, Brian H Cuthbertson, Louise Rose, Priscila Robles, Stacey Burns, Marcelo Cypel, Lianne Singer, Cecelia Chaparro, Chung-Wai Chow, Shaf Keshavjee, Laurent Brochard, Paul Hebert, Arthur S Slutsky, John C Marshall, Deborah Cook, Jill I Cameron, RECOVER Program Investigators (Phase 1: towards RECOVER), and Canadian Critical Care Trials Group.
• 1 Department of Medicine.
• Am. J. Respir. Crit. Care Med. 2016 Oct 1; 194 (7): 831-844.

RationaleDisability risk groups and 1-year outcome after greater than or equal to 7 days of mechanical ventilation (MV) in medical/surgical intensive care unit (ICU) patients are unknown and may inform education, prognostication, rehabilitation, and study design.ObjectivesTo stratify patients for post-ICU disability and recovery to 1 year after critical illness.MethodsWe evaluated a multicenter cohort of 391 medical/surgical ICU patients who received greater than or equal to 1 week of MV at 7 days and 3, 6, and 12 months after ICU discharge. Disability risk groups were identified using recursive partitioning modeling.Measurements And Main ResultsThe 7-day post-ICU Functional Independence Measure (FIM) determined the recovery trajectory to 1-year after ICU discharge and was an independent risk factor for 1-year mortality. The 7-day post-ICU FIM was predicted by age and ICU length of stay. By 2 weeks of MV, ICU patients could be stratified into four disability groups characterized by increasing risk for post ICU disability, ICU and post-ICU healthcare use, and disposition. Patients less than 42 years with ICU length of stay less than 2 weeks had the best function and fewest deaths at 1 year compared with patients greater than 66 years with ICU length of stay greater than 2 weeks who sustained the worst disability and 40% 1-year mortality. Depressive symptoms (17%) and post-traumatic stress disorder (18%) persisted at 1 year.ConclusionsICU survivors of greater than or equal to 1 week of MV may be stratified into four disability groups based on age and ICU length of stay. These groups determine 1-year recovery and healthcare use and are independent of admitting diagnosis and illness severity. Clinical trial registered with www.clinicaltrials.gov (NCT 00896220).

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