Functional and psychological features immediately after discharge from an intensive care unit: prospective cohort study

OBJECTIVE To assess the functional and psychological features of patients immediately after discharge from the intensive care unit. METHODS Prospective cohort study. Questionnaires and scales assessing the degree of dependence and functional capacity (modified Barthel and Karnofsky scales) and psychological problems (Hospital Anxiety and Depression Scale), in addition to the Epworth Sleepiness Scale, were administered during interviews conducted over the first week after intensive care unit discharge, to all survivors who had been admitted to this service from August to November 2012 and had remained longer than 72 hours. RESULTS The degree of dependence as measured by the modified Barthel scale increased after intensive care unit discharge compared with the data before admission (57 ± 30 versus 47 ± 36; p < 0.001) in all 79 participants. This impairment was homogeneous among all the categories in the modified Barthel scale (p < 0.001) in the 64 participants who were independent or partially dependent (Karnofsky score ≥ 40) before admission. The impairment affected the categories of personal hygiene (p = 0.01) and stair climbing (p = 0.04) only in the 15 participants who were highly dependent (Karnofsky score < 40) before admission. Assessment of the psychological changes identified mood disorders (anxiety and/or depression) in 31% of the sample, whereas sleep disorders occurred in 43.3%. CONCLUSIONS Patients who remained in an intensive care unit for 72 hours or longer exhibited a reduced functional capacity and an increased degree of dependence during the first week after intensive care unit discharge. In addition, the incidence of depressive symptoms, anxiety, and sleep disorders was high among that population.