Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0

Khadija Ahmed; Vitalis Mung’ayi

doi:doi:10.11648/j.ijacm.20231102.18

| Peer-Reviewed

Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0

Khadija Ahmed, Vitalis Mung’ayi

Published in International Journal of Anesthesia and Clinical Medicine (Volume 11, Issue 2)

Received: 20 August 2023 Accepted: 18 September 2023 Published: 8 October 2023

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Critical care has evolved throughout the years since the polio outbreak when the first intensive care unit (ICU) was set up in the United States of America (USA). There is an increasing number of survivors of critical illness. The survivors have been shown to have prolonged physical, cognitive and psychological impairments. There is a paucity of current information on the status of these patients post ICU in Africa. Objectives: To measure the disability status of adult patients post general Intensive Care Unit (ICU) discharge using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. To determine the factors associated with the degree of disability. Methodology: This was a cross-sectional analytical study. Patients admitted to Aga Khan University Hospital, Nairobi, (AKUHN) ICU, were on mechanical ventilation for more than forty-eight hours and survived to hospital discharge were contacted by telephone. Once they were found to be alive and consented for the study, the WHODAS 2.0 questionnaire was used. The level of disability was measured using the WHODAS 2.0 which has 12 items, where each item was scored between 0 and 4; and the total score was displayed as a percentage. Factors associated with the degree of disability were retrieved from the patients’ files. Data analysis was done using SPSS version 2.0. Results: 92 patients were enrolled into the study where 62.6% (n=57) were females. The disability status in our respondents was as follows; n=26 (28.6%) of them had no disability, n=26 (28.6%) mild disability and n=22 (24.2%) had moderate disability, n=17 (18.7%) of the patients reported severe disability while no participant had complete disability. Median age of 60 years and length of ICU stay were found to be associated with moderate to severe disability. Other factors like; duration of mechanical ventilation, number of comorbid, use of muscle relaxant/steroids, admission diagnosis was not found to be statistically significant in relation to degree of disability. Conclusion: In this study, 57.2% of patients had no disability to mild disability while 42.8% were found to have moderate to severe disability. Patients who were found to have moderate to severe disability had longer ICU stay and were in the older population.

Published in	International Journal of Anesthesia and Clinical Medicine (Volume 11, Issue 2)
DOI	10.11648/j.ijacm.20231102.18
Page(s)	98-105
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Disability, Critical Care Survivors, Post ICU Discharge, Physical Impairment, Mechanical Ventilation, Quality of Life

References

[1]	Marshall JC, Bosco L, Adhikari NK, Connolly B, Diaz JV, Dorman T, Fowler RA, Meyfroidt G, Nakagawa S, Pelosi P, Vincent JL, Vollman K, Zimmerman J. What is an Intensive care unit? A report of the task force of the World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care. 2017; (37): 270-276. https://doi.org/10.1016/j.jcrc.2016.07.015
[2]	Kelly EF, Fong K, Hirsch N, Nolan JP. Intensive care medicine is 60 years old: the history and future of the intensive care unit. Clin Med (Lond). 2014; 14 (4): https://doi.org/10.7861/clinmedicine.14-4-376
[3]	Rosa RG, Ferreira GE, Viola TW, Robinson CC, Kochhann R, Berto PP, Biason L, Cardoso PR, Falavigna M, Teixeira C. Effects of post-ICU follow-up on subject outcomes: A systematic review and meta-analysis. J Crit Care. 2019; 52: 115-125. https://doi.org/10.1016/j.jcrc.2019.04.014
[4]	Denehy, L., Hough, C. L. Critical illness, disability, and the road home. Intensive Care Med. 2017; 43: 1881–1883. https://doi.org/10.1007/s00134-017-4942-6
[5]	Ustun, Tevfik Bedirhan, Kostanjesek, N, Chatterji, S, Rehm, J & World Health Organization. (‎2010)‎. Measuring health and disability: manual for WHO Disability Assessment Schedule (‎WHODAS 2.0)‎ / edited by T. B. Üstün, N. Kostanjsek, S. Chatterji, J. Rehm. World Health Organization. https://apps.who.int/iris/handle/10665/43974
[6]	Marx BP, Wolf EJ, Cornette MM, Schnurr PP, Rosen MI, Friedman MJ, Keane TM, Speroff T. Using the WHODAS 2.0 to Assess Functioning Among Veterans Seeking Compensation for Posttraumatic Stress Disorder. Psychiatr Serv. 2015; 66 (12): 1312-7. https://doi.org/10.1176/appi.ps.201400400
[7]	Bindt C, Appiah-Poku J, Te Bonle M, Schoppen S, Feldt T, Barkmann C, Koffi M, Baum J, Nguah SB, Tagbor H, Guo N, N'Goran E, Ehrhardt S; International CDS Study Group. Antepartum depression and anxiety associated with disability in African women: cross-sectional results from the CDS study in Ghana and Côte d'Ivoire. PLoS One. 2012; 7 (10): e48396. https://doi.org/10.1371/journal.pone.0048396
[8]	Kietrys D, Myezwa H, Galantino ML, Parrott JS, Davis T, Levin T, O'Brien K, Hanass-Hancock J. Functional Limitations and Disability in Persons Living with HIV in South Africa and United States: Similarities and Differences. J Int Assoc Provid AIDS Care. 2019 Jan-Dec; 18: 2325958219850558. https://doi.org/10.1177/2325958219850558
[9]	Hodgson CL, Udy AA, Bailey M, Barrett J, Bellomo R, Bucknall T, Gabbe BJ, Higgins AM, Iwashyna TJ, Hunt-Smith J, Murray LJ, Myles PS, Ponsford J, Pilcher D, Walker C, Young M, Cooper DJ. The impact of disability in survivors of critical illness. Intensive Care Med. 2017 Jul; 43 (7): 992-1001. https://doi.org/10.1007/s00134-017-4830-0
[10]	Andrews G, Kemp A, Sunderland M, Von Korff M, Ustun TB. Normative data for the 12 item WHO Disability Assessment Schedule 2.0. PLoS One. 2009; 4 (12): e8343. https://doi.org/10.1371/journal.pone.0008343
[11]	Lukoko LN, Kussin PS, Adam RD, Orwa J, Waweru-Siika W. Investigating SOFA, delta-SOFA and MPM-III for mortality prediction among critically ill patients at a private tertiary hospital ICU in Kenya: A retrospective cohort study. PLoS One. 2020; 15 (7): 1–14. http://doi.org/10.1371/journal.pone.0235809
[12]	Lalani HS, Waweru-Siika W, Mwogi T, Kituyi P, Egger JR, Park LP, Kussin PS. Intensive Care Outcomes and Mortality Prediction at a National Referral Hospital in Western Kenya. Ann Am Thorac Soc. 2018 Nov; 15 (11): 1336-1343. https://doi.org/10.1513/AnnalsATS.201801-051OC
[13]	Griffiths J, Hatch RA, Bishop J, Morgan K, Jenkinson C, Cuthbertson BH, Brett SJ. An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study. Crit Care. 2013; 17 (3): R100. https://doi.org/10.1186/cc12745
[14]	Neuman MD, Werner RM. Marital Status and Postoperative Functional Recovery. JAMA Surg. 2016; 151 (2): 194-6. https://doi.org/10.1001/jamasurg.2015.3240
[15]	Barnato AE, Albert SM, Angus DC, Lave JR, Degenholtz HB. Disability among elderly survivors of mechanical ventilation. Am J Respir Crit Care Med. 2011; 183 (8): 1037-42. https://doi.org/10.1164/rccm.201002-0301OC
[16]	Rawal G, Yadav S, Kumar R. Post-intensive Care Syndrome: An Overview. J Transl Int Med. 2017; 5 (2): 90-92. https://doi.org/10.1515/jtim-2016-0016
[17]	Istvan M. Majer, Wilma J. Nusselder, Johan P. Mackenbach, Bart Klijs, and Pieter H. M. van Baal, 2011: Mortality Risk Associated With Disability: A Population-Based Record Linkage Study American Journal of Public Health 201; 101, e9_e15, https://doi.org/10.2105/AJPH.2011.300361

Cite This Article

Plain Text BibTeX RIS

APA Style

Khadija Ahmed, Vitalis Mung’ayi. (2023). Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0. International Journal of Anesthesia and Clinical Medicine, 11(2), 98-105. https://doi.org/10.11648/j.ijacm.20231102.18

Copy | Download

ACS Style

Khadija Ahmed; Vitalis Mung’ayi. Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0. Int. J. Anesth. Clin. Med. 2023, 11(2), 98-105. doi: 10.11648/j.ijacm.20231102.18

Copy | Download

AMA Style

Khadija Ahmed, Vitalis Mung’ayi. Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0. Int J Anesth Clin Med. 2023;11(2):98-105. doi: 10.11648/j.ijacm.20231102.18

Copy | Download

@article{10.11648/j.ijacm.20231102.18,
  author = {Khadija Ahmed and Vitalis Mung’ayi},
  title = {Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {11},
  number = {2},
  pages = {98-105},
  doi = {10.11648/j.ijacm.20231102.18},
  url = {https://doi.org/10.11648/j.ijacm.20231102.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20231102.18},
  abstract = {Background: Critical care has evolved throughout the years since the polio outbreak when the first intensive care unit (ICU) was set up in the United States of America (USA). There is an increasing number of survivors of critical illness. The survivors have been shown to have prolonged physical, cognitive and psychological impairments. There is a paucity of current information on the status of these patients post ICU in Africa. Objectives: To measure the disability status of adult patients post general Intensive Care Unit (ICU) discharge using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. To determine the factors associated with the degree of disability. Methodology: This was a cross-sectional analytical study. Patients admitted to Aga Khan University Hospital, Nairobi, (AKUHN) ICU, were on mechanical ventilation for more than forty-eight hours and survived to hospital discharge were contacted by telephone. Once they were found to be alive and consented for the study, the WHODAS 2.0 questionnaire was used. The level of disability was measured using the WHODAS 2.0 which has 12 items, where each item was scored between 0 and 4; and the total score was displayed as a percentage. Factors associated with the degree of disability were retrieved from the patients’ files. Data analysis was done using SPSS version 2.0. Results: 92 patients were enrolled into the study where 62.6% (n=57) were females. The disability status in our respondents was as follows; n=26 (28.6%) of them had no disability, n=26 (28.6%) mild disability and n=22 (24.2%) had moderate disability, n=17 (18.7%) of the patients reported severe disability while no participant had complete disability. Median age of 60 years and length of ICU stay were found to be associated with moderate to severe disability. Other factors like; duration of mechanical ventilation, number of comorbid, use of muscle relaxant/steroids, admission diagnosis was not found to be statistically significant in relation to degree of disability. Conclusion: In this study, 57.2% of patients had no disability to mild disability while 42.8% were found to have moderate to severe disability. Patients who were found to have moderate to severe disability had longer ICU stay and were in the older population.},
 year = {2023}
}

Copy | Download

TY - JOUR
T1 - Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0
AU - Khadija Ahmed
AU - Vitalis Mung’ayi
Y1 - 2023/10/08
PY - 2023
N1 - https://doi.org/10.11648/j.ijacm.20231102.18
DO - 10.11648/j.ijacm.20231102.18
T2 - International Journal of Anesthesia and Clinical Medicine
JF - International Journal of Anesthesia and Clinical Medicine
JO - International Journal of Anesthesia and Clinical Medicine
SP - 98
EP - 105
PB - Science Publishing Group
SN - 2997-2698
UR - https://doi.org/10.11648/j.ijacm.20231102.18
AB - Background: Critical care has evolved throughout the years since the polio outbreak when the first intensive care unit (ICU) was set up in the United States of America (USA). There is an increasing number of survivors of critical illness. The survivors have been shown to have prolonged physical, cognitive and psychological impairments. There is a paucity of current information on the status of these patients post ICU in Africa. Objectives: To measure the disability status of adult patients post general Intensive Care Unit (ICU) discharge using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. To determine the factors associated with the degree of disability. Methodology: This was a cross-sectional analytical study. Patients admitted to Aga Khan University Hospital, Nairobi, (AKUHN) ICU, were on mechanical ventilation for more than forty-eight hours and survived to hospital discharge were contacted by telephone. Once they were found to be alive and consented for the study, the WHODAS 2.0 questionnaire was used. The level of disability was measured using the WHODAS 2.0 which has 12 items, where each item was scored between 0 and 4; and the total score was displayed as a percentage. Factors associated with the degree of disability were retrieved from the patients’ files. Data analysis was done using SPSS version 2.0. Results: 92 patients were enrolled into the study where 62.6% (n=57) were females. The disability status in our respondents was as follows; n=26 (28.6%) of them had no disability, n=26 (28.6%) mild disability and n=22 (24.2%) had moderate disability, n=17 (18.7%) of the patients reported severe disability while no participant had complete disability. Median age of 60 years and length of ICU stay were found to be associated with moderate to severe disability. Other factors like; duration of mechanical ventilation, number of comorbid, use of muscle relaxant/steroids, admission diagnosis was not found to be statistically significant in relation to degree of disability. Conclusion: In this study, 57.2% of patients had no disability to mild disability while 42.8% were found to have moderate to severe disability. Patients who were found to have moderate to severe disability had longer ICU stay and were in the older population.
VL - 11
IS - 2
ER -

Copy | Download

Author Information

Khadija Ahmed

Department of Anaesthesia, Aga Khan University, Nairobi, Kenya
Vitalis Mung’ayi

Department of Anaesthesia, Aga Khan University, Nairobi, Kenya

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Khadija Ahmed, Vitalis Mung’ayi. (2023). Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0. International Journal of Anesthesia and Clinical Medicine, 11(2), 98-105. https://doi.org/10.11648/j.ijacm.20231102.18

Copy | Download

ACS Style

Khadija Ahmed; Vitalis Mung’ayi. Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0. Int. J. Anesth. Clin. Med. 2023, 11(2), 98-105. doi: 10.11648/j.ijacm.20231102.18

Copy | Download

AMA Style

Khadija Ahmed, Vitalis Mung’ayi. Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0. Int J Anesth Clin Med. 2023;11(2):98-105. doi: 10.11648/j.ijacm.20231102.18

Copy | Download

@article{10.11648/j.ijacm.20231102.18,
  author = {Khadija Ahmed and Vitalis Mung’ayi},
  title = {Determining the Disability Status of Adult Patients Post General Intensive Care Unit Discharge using the World Health Organization Disability Assessment Schedule 2.0},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {11},
  number = {2},
  pages = {98-105},
  doi = {10.11648/j.ijacm.20231102.18},
  url = {https://doi.org/10.11648/j.ijacm.20231102.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20231102.18},
  abstract = {Background: Critical care has evolved throughout the years since the polio outbreak when the first intensive care unit (ICU) was set up in the United States of America (USA). There is an increasing number of survivors of critical illness. The survivors have been shown to have prolonged physical, cognitive and psychological impairments. There is a paucity of current information on the status of these patients post ICU in Africa. Objectives: To measure the disability status of adult patients post general Intensive Care Unit (ICU) discharge using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. To determine the factors associated with the degree of disability. Methodology: This was a cross-sectional analytical study. Patients admitted to Aga Khan University Hospital, Nairobi, (AKUHN) ICU, were on mechanical ventilation for more than forty-eight hours and survived to hospital discharge were contacted by telephone. Once they were found to be alive and consented for the study, the WHODAS 2.0 questionnaire was used. The level of disability was measured using the WHODAS 2.0 which has 12 items, where each item was scored between 0 and 4; and the total score was displayed as a percentage. Factors associated with the degree of disability were retrieved from the patients’ files. Data analysis was done using SPSS version 2.0. Results: 92 patients were enrolled into the study where 62.6% (n=57) were females. The disability status in our respondents was as follows; n=26 (28.6%) of them had no disability, n=26 (28.6%) mild disability and n=22 (24.2%) had moderate disability, n=17 (18.7%) of the patients reported severe disability while no participant had complete disability. Median age of 60 years and length of ICU stay were found to be associated with moderate to severe disability. Other factors like; duration of mechanical ventilation, number of comorbid, use of muscle relaxant/steroids, admission diagnosis was not found to be statistically significant in relation to degree of disability. Conclusion: In this study, 57.2% of patients had no disability to mild disability while 42.8% were found to have moderate to severe disability. Patients who were found to have moderate to severe disability had longer ICU stay and were in the older population.},
 year = {2023}
}

Copy | Download