The association between self-reported symptoms, rehabilitation and long-term functional disability in ICU survivors

The relationship between self-reported symptoms and functional disability in ICU survivors remains unclear. Rehabilitation is considered necessary in supporting ICU survivors' recovery and functional outcomes, though evidence remains inconclusive. To investigate the association between self-reported symptoms and the role of post-ICU rehabilitation on functional disability in ICU survivors. Functional disability was measured using the Lawton Instrumental Activities of Daily Living (I-ADL) scale, dichotomised as "with or without disabilities" based on established threshold. Data were collected pre-ICU and at 3, 6, and 12 months post-ICU admission. To account for repeated measures over time, generalised linear model for repeated measures with a binary outcome was used to estimate possible predictive factors associated with functional disability. Separate analyses were performed for patients who did and did not receive post-ICU rehabilitation. Among 331 included ICU survivors, 165 (49.8 %) received post-ICU rehabilitation during the first year. A higher level of pain/discomfort (OR = 1.47; 95 %CI: [1.13-1.91]), higher PTSS score (OR = 1.05; 95 %CI: [1.03-1.07]), and higher depression score (OR = 1.13; 95 % CI: [1.05-1.22]) at three months were associated with functional disability during the first year. The odds of having functional disability were lower at twelve-month follow-up compared to three-month follow-up (OR = 0.46; 95 %CI: [0.26-0.83]). Patients who received rehabilitation had lower odds of having functional disability both at six months (OR = 0.42; 95 %CI: [0.18-0.95]) and at twelve months (OR = 0.36; 95 %CI: [0.16-0.82]). Self-reported symptoms at three months were associated with having functional disability in ICU survivors during the first year. ICU survivors who received post-ICU rehabilitation had improved functional disability compared to those who did not receive rehabilitation. Our study underscores the importance of screening self-reported symptoms during post-ICU follow-up and the potential role of post-ICU rehabilitation in improving functional disability among ICU survivors.