Physical Function Trajectories in Survivors of Acute Respiratory Failure
Physical Function Trajectories in Survivors of Acute Respiratory Failure
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DOI：
10.1513/annalsats.201806-375oc
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发表时间：
2019-04-01
影响因子：
8.3
通讯作者：
Morris, Peter E.
中科院分区：
文献类型：
--
作者：
Gandotr, Sheetal;Lovato, James;Morris, Peter E.
基本原理：危重病患者的生存率有所提高，但对危重病患者功能恢复的影响因素仍不完全清楚。目的：确定急性呼吸衰竭（ARF）幸存者出院后具有相似身体功能恢复模式的群体，并确定每个身体功能轨迹组中与群体成员资格相关的特征。我们对一项随机对照试验进行了二次分析，使用基于组的轨迹模型来识别ARF后具有相似身体功能恢复模式的不同亚组患者。卡方检验和单因素方差分析用于确定哪些变量与轨迹隶属度相关。进行多项逻辑回归分析，以确定变量共同与轨迹组membership.Results：共260例患者参加了一项试验，评估标准化的康复治疗与ARF患者出院活着（NCT 00976833）被列入本分析。在出院时和入组后2、4和6个月，使用短期身体功能成套测试对身体功能进行量化。对短期体能成套测验评分的潜在类别分析确定了四个轨迹组。这些群体在身体功能恢复的程度和速度上都有差异。使用文献中先前确定的影响危重病后恢复的协变量进行多项logistic回归分析。多项Logistic回归分析显示，年龄（P
Rationale: Survivorship from critical illness has improved; however, factors mediating the functional recovery of persons experiencing a critical illness remain incompletely understood.Objectives: To identify groups of acute respiratory failure (ARF) survivors with similar patterns of physical function recovery after discharge and to determine the characteristics associated with group membership in each physical function trajectory group.Methods: We performed a secondary analysis of a randomized controlled trial, using group-based trajectory modeling to identify distinct subgroups of patients with similar physical function recovery patterns after ARF. Chi-square tests and one-way analysis of variance were used to determine which variables were associated with trajectory membership. A multinomial logistic regression analysis was performed to identify variables jointly associated with trajectory group membership.Results: A total of 260 patients enrolled in a trial evaluating standardized rehabilitation therapy in patients with ARF and discharged alive (NCT00976833) were included in this analysis. Physical function was quantified using the Short Physical Performance Battery at hospital discharge and 2, 4, and 6 months after enrollment. Latent class analysis of the Short Physical Performance Battery scores identified four trajectory groups. These groups differ in both the degree and rate of physical function recovery. A multinomial logistic regression analysis was performed using covariates that have been previously identified in the literature as influencing recovery after critical illness. By multinomial logistic regression, age (P