Journal article
Identifying Comorbid Subtypes of Patients With Acute Respiratory Failure
American journal of critical care, Vol.32(4), pp.294-301
07/01/2023
DOI: 10.4037/ajcc2023980
PMCID: PMC10715624
PMID: 37391366
Abstract
BACKGROUND Patients with acute respiratory failure have multiple risk factors for disability following their intensive care unit stay. Interventions to facilitate independence at hospital discharge may be more effective if personalized for patient subtypes. OBJECTIVES To identify subtypes of patients with acute respiratory failure requiring mechanical ventilation and compare post-intensive care functional disability and intensive care unit mobility level among subtypes. METHODS Latent class analysis was conducted in a cohort of adult medical intensive care unit patients with acute respiratory failure receiving mechanical ventilation who survived to hospital discharge. Demographic and clinical medical record data were collected early in the stay. Clinical characteristics and outcomes were compared among subtypes by using Kruskal-Wallis tests and χ2 tests of independence. RESULTS In a cohort of 934 patients, the 6-class model provided the optimal fit. Patients in class 4 (obesity and kidney impairment) had worse functional impairment at hospital discharge than patients in classes 1 through 3. Patients in class 3 (alert patients) had the lowest magnitude of functional impairment (P < .001) and achieved the earliest out-of-bed mobility and highest mobility level of all subtypes (P < .001). CONCLUSIONS Acute respiratory failure survivor subtypes identified from clinical data available early in the intensive care unit stay differ in post-intensive care functional disability. Future research should target high-risk patients in early rehabilitation trials in the intensive care unit. Additional investigation of contextual factors and mechanisms of disability is critical to improving quality of life in acute respiratory failure survivors.
Details
- Title: Subtitle
- Identifying Comorbid Subtypes of Patients With Acute Respiratory Failure
- Creators
- Kelly M Potter - Medical University of South CarolinaHeather Dunn - University of IowaAnna Krupp - University of IowaMartina Mueller - Medical University of South CarolinaSusan Newman - Medical University of South CarolinaTimothy D Girard - University of PittsburghSarah Miller - Medical University of South Carolina
- Resource Type
- Journal article
- Publication Details
- American journal of critical care, Vol.32(4), pp.294-301
- DOI
- 10.4037/ajcc2023980
- PMID
- 37391366
- PMCID
- PMC10715624
- ISSN
- 1062-3264
- eISSN
- 1937-710X
- Language
- English
- Date published
- 07/01/2023
- Academic Unit
- Nursing
- Record Identifier
- 9984442027102771
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