713: Pulmonary Rehabilitation Participation After Surviving Critical Illness

Introduction: Pulmonary rehabilitation after critical illness for acute respiratory failure has a positive impact on patients’ lives by improving their functional outcomes and independence. However, evidence to identify participation in pulmonary rehabilitation (PR) is limited. The purpose of this study is to identify the relationship between patient characteristics and clinical course with participation in PR and functional outcomes. Methods: This prospective study enrolled patients who survived critical illness at the University of Kentucky. Social determinants of health data (SDOH) data were collected using a validated screener 3 months after hospital discharge. Patient demographics, clinical course information and functional outcomes during PR were extracted from the electronic health record (EHR). Grouped t-tests, chi-square and correlations were completed for statistical analysis. Results: Of 42 patients enrolled in the study, 26 attended PR after ICU discharge with an equal number of male and female patients with an average age of 56.8 ± 9.0 years and BMI of 26.7 ± 5.4 kg/m2. Patients with greater severity of illness upon hospital admission determined by the Sequential Organ Failure Assessment (SOFA) (r= -0.353, p=0.028) were less likely to attend PR after discharge. Additionally, those that reported being a caregiver prior to ICU admission had better functional outcomes measured by the 5 times sit to stand (t= 9, p= 0.046), gait speed (t= 66.5, p= 0.005), Short Physical Performance Battery (t= 60, p= 0.042), Timed Up and Go (t= 7.5, p= 0.010), and distance ambulated in the 6 minute walk test (t= 69, p= 0.002), compared to those that were not a caregiver. Of the patients who reported unmet social needs, a trend was observed where all (n=12) the patients who reported 1-2 unmet needs attended PR whereas 33% (n=1) of the patients who reported 5-6 unmet needs attended. A similar clinically relevant trend was reflected with only 33% (n=2) of patients who reported food insecurity attending PR. Conclusions: Barriers to participating in pulmonary rehabilitation after discharge are related to patients’ societal roles and their health prior to an ICU stay as well as their clinical course during the hospital. Addressing barriers to attending pulmonary rehabilitation may improve patient recovery.