What question did this study set out to answer?

This study aims to explore the gap between functional independence and perceived health in ICU survivors using different assessment tools.

May 20, 2026

D25-17 Discordance Between Functional Independence and Perceived Health After ICU

Key Points

This study aims to explore the gap between functional independence and perceived health in ICU survivors using different assessment tools.
Cross-sectional study of 52 survivors of respiratory critical illness requiring mechanical ventilation.
Assessments conducted 6-12 months post-ICU discharge using Barthel Index, SF-36, and EQ-5D-3L.
Clinical discordance defined using specific thresholds for BI and PROM domains.
Mean Barthel Index was 91.3 (±14.1), indicating functional independence.
Clinical discordance was observed in 32.7% for General Health (GH < 50) and 75% for Visual Analogue Scale (VAS < 50).
Discordance was more prevalent in younger survivors (41.7% < 65 years for GH < 50) compared to older survivors.

Abstract

Abstract Introduction The Barthel Index (BI) is widely used to assess functional independence after critical illness. Although it demonstrates strong reliability and prognostic value, some studies suggest that it may be highly specific but poorly sensitive in detecting subtle or multidimensional impairments in health-related quality of life (HRQoL). Patients may regain autonomy in basic activities of daily living (ADL) yet continue to experience fatigue, pain, or psychological limitations not captured by the BI. We tested the hypothesis that ICU survivors would show a discordance between functional recovery (BI) and perceived health evaluated through the SF-36 and EQ-5D-3L questionnaires. Method A cross-sectional study was conducted including 52 survivors of respiratory critical illness who required mechanical ventilation. Assessments were performed 6-12 months after ICU discharge using the Barthel Index (0-100), the SF-36 (domains: Physical Functioning PF, Role Physical RP, Bodily Pain BP, General Health GH, Vitality VT), and the EQ-5D-3L (utility index UTIL5D, 0-1 and visual analogue scale VAS, 0-100). Clinical discordance was defined as BI ≥ 90 combined with (a) PF 50 or GH 50 (SF-36), (b) UTIL5D 0.80, or (c) VAS 50. t-tests and Pearson correlations were used to compare BI with each PROM domain. Results Mean (±SD) scores were: BI 91.3±14.1; PF 76.4±25.3; RP 46.6±47.2; BP 60.3±24.4; GH 47.3±24.8; VT 44.1±20.7; UTIL5D 0.695±0.213; VAS 0.734±0.186; Age 52.7±15.6; APACHE II 14.8±4.4; SOFA 7.3±2.9; ICU stay 12.6±7.8 days; and Mechanical Ventilation 9.4±5.6 days. Correlations between BI and SF-36 domains were: PF r = 0.80 (p 0.001), RP r = 0.56, BP r = 0.57, GH r = 0.42, and VT r = 0.43. Clinical discordance was observed in 3.8% (PF 50), 32.7% (GH 50), 59.6% (UTIL5D0.80), and 75.0% (VAS50) of patients. Discordance was more frequent among younger survivors (65 years: 41.7% vs ≥ 65 years: 12.5% for GH 50). Conclusion Despite recovering functional independence (BI ≥ 90), a substantial proportion of ICU survivors report poor perceived health and quality of life. These findings suggest that the BI is specific but not sensitive in detecting post-ICU HRQoL impairments. Integrating PROMs such as SF-36 and EQ-5D-3L (including VAS) may improve detection of residual physical, emotional, and social limitations, guiding patient-centered rehabilitation strategies. This abstract is funded by: None

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