Key result
Lower functional status at ICU admission is linked to more social-work interventions.
Why the study?
Patients with chronic pulmonary disease often have baseline functional limitations and may need greater social-work support, but this relationship remains poorly characterized.
Observational (n=160)
No
Absolute Event Rate: 4% vs 3%
p-value: p=0.02
Lower functional status at ICU admission is independently associated with increased social-work involvement, particularly in patients with chronic pulmonary disease.
Lower AM-PAC scores may signal greater social-work needs in respiratory patients; leaves open whether functional screening alters resource use or outcomes.
Background Functional impairment is common among critically ill patients and predicts recovery, discharge disposition, and psychosocial needs. Early assessment of physical function can identify those requiring additional rehabilitation and coordinated discharge planning. Social workers play a key role in addressing these needs through counseling, financial assistance, and post-acute care coordination. Patients with chronic pulmonary disease (CPD) often have baseline limitations and may require greater social-work support, yet this relationship remains poorly characterized. Objective To evaluate whether functional status at ICU admission, measured by the AM-PAC “6-Clicks” score, is associated with the number of social-worker interventions, and whether this relationship differs between patients with and without CPD. Methods A prospective observational study of 160 adult patients admitted to a tertiary-care Medical ICU over 3 months. Functional status was measured using the AM-PAC “6-Clicks.” Social-work activity was categorized across ∼30 intervention types, including discharge planning, family counseling, post-acute coordination, financial assistance, mental-health support, transportation, and home-care referral. The total number of interventions per patient was recorded. Patients were grouped as CPD (n = 36, 23%) or non-CPD (n = 124, 77%). Continuous variables were compared using Mann-Whitney U tests, and multivariable linear regression assessed the association between AM-PAC and number of interventions, adjusting for age, SOFA score, and Charlson Index. Results Among 160 patients (55% male, mean age 63 ± 14 years), leading diagnoses included respiratory failure (52%) and sepsis (35%). CPD patients had lower AM-PAC scores (14.7 ± 6.3 vs 15.9 ± 6.0; p = 0.40) and more social-work interventions (median 4 [IQR 2-7] vs 3 [IQR 1-5]; p = 0.02). The most common interventions were discharge planning (71%), family support (62%), post-acute coordination (51%), and financial/insurance assistance (46%). In adjusted analysis, lower AM-PAC scores independently predicted a higher number of interventions (β = -0.34; p = 0.009). CPD remained a significant modifier (p = 0.04), indicating greater psychosocial and discharge-related needs. Conclusions Lower functional status at ICU admission was strongly and independently associated with increased social-work involvement. Patients with CPD demonstrated both reduced functionality and greater reliance on social-work services. Early identification of functionally impaired patients—particularly those with CPD—may optimize rehabilitation, psychosocial support, and discharge planning in the ICU setting.
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Sarver et al. (2026) conducted an observational in Chronic pulmonary disease in critically ill patients (n=160). Chronic pulmonary disease (CPD) vs. Non-CPD was evaluated on Number of social-worker interventions (p=0.02). Lower functional status at ICU admission independently predicted a higher number of social-work interventions (β = -0.34; p=0.009), with CPD patients requiring more interventions (median 4 vs 3).
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