Assessing functional status after intensive care unit stay: the Barthel Index and the Katz Index.

Int J Qual Health Care

Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy - Medical School of the University of São Paulo, Rua Cipotânea 51, Cidade Universitária, 05360-000 São Paulo-SP, Brazil.

Published: May 2018

Objective: To assess the functional status of post-ICU patients using the Barthel Index (BI) and the Katz Index (KI) and to assess which is more suitable for this population.

Design: Retrospective longitudinal study.

Setting: Public tertiary hospital in São Paulo (Brazil).

Participants: Patients aged ≥18 years old, admitted to ICU, who were treated with mechanical ventilation (MV) ≥ 24 h and were discharged to ward.

Exclusion Criteria: Inability to answer the BI and the KI; limiting neurological or orthopaedic conditions; ICU stay ≥90 days. Patients transferred to or from other hospitals or who died in the wards were not analysed.

Intervention: BI and KI were scored pre-ICU and post-ICU and the variation was calculated.

Main Outcome Measures: BI and KI scores were compared using analysis based on item response theory (IRT), using degree of difficulty and discriminating items as parameters.

Results: Median age was 52 years old, median APACHE II score was 15. Median ICU stay was 11 days and median MV duration was 4 days. BI variation was 44% and KI variation was 55%. In IRT analysis, BI considered a larger number of items with different levels of difficulty.

Conclusion: Both the BI and the KI revealed significant deterioration of functional status after ICU discharge. The IRT analysis suggested that the Barthel Index might be a better scale than the Katz Index for the assessment of functional status of patients discharged from ICU, since it presented better discrimination of the ability to carry out the tasks.

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Source
http://dx.doi.org/10.1093/intqhc/mzx203DOI Listing

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