Critical Illness
Conditions
Keywords
Falls, Intensive care
Brief summary
Understanding the Impact of Critical Illness on Falls Risk - a 12 Month Observational Study
Detailed description
This observational study aims to investigate the incidence and risk factors for falls in the first 12 months post hospital discharge in patients following an ICU admission. It also aims to determine factors at hospital discharge which may predict future falls risk at 12 months and examine the physical activity levels of ICU survivors. Furthermore, it also will investigate the relationship between falls, fear of falling and activity limitations and participation restriction. All adult patients in intensive care that have been mechanically ventilated for over 48 hours, and remain in the ICU at least 4 days will be considered for inclusion. The primary outcome measure is a 12 month falls diary which commences on hospital discharge. There will also be Physiotherapy assessments just prior to hospital discharge, 3, 6, and 12 months post hospital discharge.
Interventions
None listed
Sponsors
Melbourne Health
University of Kentucky
University of Melbourne
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* hospitalised adults aged 18 years * with an ICU admission requiring invasive mechanical ventilation for at least 48 hours and remain in ICU \> 4 days
Exclusion criteria
* Pregnant * Insufficient English language skills to read and understand questionnaires and patient information consent form * Pre-existing documented cognitive impairment * Spinal cord injury or other primary neuromuscular disease or new brain injury * Patient unable to be followed up due to geographic location * New lower limb fracture on this admission * Liver failure with abdominal distension due to ascites requiring fortnightly drainage * Recent history of stroke or major surgery affecting lower limb e.g. Total knee or hip replacement in the past 12 weeks * Neurological disorders such as Parkinson disease or multiple sclerosis * Poor premorbid function defined as \<10 metres ambulation +/- gait aid independently * Frequent falls history defined as 3 or more falls over 2 months * incarcerated or safety concerns for follow up * discharged to palliative hospice facility * not expected to survive to 3 months post hospital discharge * unable to provide informed consent before hospital discharge due to current cognitive state (e.g. delirium, psychosis)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Falls calendar - number of falls per month for 12 months, self-recorded by participant | One per month for 12 months | 12-monthly falls calendar - This will record time to first fall, falls, incidence, number of falls including injurious falls. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hand held dynamometry | Baseline, 3, 6, and 12 months post discharge | Muscle strength |
| mini-BEST | Baseline, 3, 6, and 12 months post discharge | Balance |
| 4 metre walk test | Baseline, 3, 6, and 12 months post discharge | Gait |
| MoCA | Baseline, 3, 6, and 12 months post discharge | Cognitive |
| Physical activity levels | Baseline, 3, 6, and 12 months post discharge | Physical activity as measured as per title. Assessed using a physical activity tracker that participants will wear. |
| Clinical frailty scale questionairre | Baseline, 3, 6, and 12 months post discharge | Frailty |
| Falls Risk for Older People in the Community Setting (FROP-com) Questionairre | 3, 6, and 12 months post discharge | Falls risk |
| Fall efficacy scale questionnaire (version: FES-International short form) | Baseline, 3, 6, and 12 months post discharge | Individuals are asked to rate, on a four-point Likert scale, their concerns about the possibility of falling when performing 16 activities. |
| Hospital Anxiety and Depression Scale (HADS) Questionairre | Baseline, 3, 6, and 12 months post discharge | It is a self-rating scale that measures anxiety and depression in both hospital and community settings. |
| EuroQol five dimensions questionnaire (version: EQ-5D-5L) | Baseline, 3, 6, and 12 months post discharge | Self-reported health-related quality of life questionnaire. |
| Muscle ultrasound imaging | Baseline, 3, 6, and 12 months post discharge | Ultrasound of rectus femoris and tibialis anterior |
| Short Physical Performance Battery | Baseline, 3, 6, and 12 months post discharge | physical test evaluation of balance, strength, and walking ability |
| Healthcare usage | 3, 6, and 12 months post discharge | Categorise readmissions and what health services are used post hospital discharge |
| FACIT Fatigue Scale (in subgroup) | 3, 6 and 12 months | Fatigue levels self report questionnaire |
| Sedentary behaviour questionnaire (in subgroup) | 3, 6, and 12 months | Weekend and weekday questionnaire of sedentary behaviour in hours |
| Conor Davidson Resilience Questionnaire (in subgroup) | 3, 6, and 12 months | self report resilience questionnaire |
| Life Orientation Revised Optimism Scale (in subgroup) | 3, 6, and 12 months | 10 item self report optimism scale, higher scores indicate higher optimism |
| Pittsburgh Sleep Quality Index (in subgroup) | 3, 6, and 12 months | questionnaire that evaluates sleep quality, higher scores indicate poorer sleep |
| MYMOP2 (in subgroup) | 3, 6, and 12 months | short questionnaire which asks patients to rate their top problems and activity limitations |
| Memorial symptoms questionnaire short form | 3, 6, and 12 months | questionnaire which covers different symptoms and how much it bothers the patient on a likert scale |
| Return to work | 3, 6 and 12 months | questionnaire which provides time to return to work and impact on finances |
| Impact of Event Scale questionnaire (version: IES-R) | Baseline, 3, 6, and 12 months post discharge | It is a self-reported questionnaire that measures It measures the severity of intrusion, avoidance, and hypervigilance symptoms, experienced over the past week. |
Countries
Australia, United States
Outcome results
None listed