Impairment In Adult Patients Research Articles

Blood biomarkers to detect functional impairment in adult patients with repaired Tetralogy of Fallot

Abstract Background The relationship between plasma brain natriuretic peptide (NT-proBNP) and soluble suppression of tumorigenicity-2 (sST2) with structural adaptions and exercise capacity remains incompletely described in patients with repaired Tetralogy of Fallot (rTOF). Methods Peripheral venous blood samples were drawn for 99 patients with repaired TOF, 59 patients with severe pulmonary regurgitation (PR) and 40 patients with no or mild PR. NT-proBNP was measured using enzyme-linked immunosorbent assays (Roche Diagnostics, Indianapolis, IN). Soluble ST2 levels were assessed on Aspect-plus ST2 quantitative rapid test. Results The mean value of NT-proBNP was 160±137 pg/ml, and sST2 was 29±13, ng/ml in the entire population. Mean NT-proBNP was significantly higher in patients with severe PR (169±150 vs145±118, pg/ml, p<0.001), while similar sST2 levels were observed in both groups (29±14 vs30±12, ng/ml, p>0.05). NT-proBNP and sST2 levels were higher in patients with transannular patch when compared to other RVOT intervention. Both biomarkers were significantly associated with exercise capacity, but NT-proBNP (r=-.60, p<0.001) was stronger. The optimal cut-off of 90pg/ml for NT-proBNP had a sensitivity of 74% and specificity of 63% for detection of impaired exercise capacity. Conclusions Serum levels of sST2 and NT-proBNP are elevated in patients with repaired TOF, with higher values observed in those with severe PR, but also in patients undergoing transannular patch. Incorporating both markers in these patients increased the ability to detect impairment in exercise capacity.

Impact of Surgical Revascularization on Regression of Enlarged Perivascular Spaces in Adult Moyamoya Disease.

Previous studies have suggested that enlarged perivascular spaces (EPVSs) are potential radiological markers of cerebral ischemia in moyamoya disease (MMD). However, serial changes in EPVSs after surgical revascularization have not yet been clarified. We aimed to elucidate the postoperative changes in EPVSs in adult patients with MMD, clinical and radiological factors affecting the number of EPVSs, and the degree of postoperative changes. We counted the EPVSs in the centrum semiovale in each hemisphere on a T2-weighted MRI performed before surgery. EPVSs were quantified 3months and 2years after combined bypass surgery in surgically treated patients and compared with the number of EPVSs before surgery. We performed multivariate logistic regression analysis to identify the clinical and radiological factors associated with the number of EPVSs. This study included 120 hemispheres of 65 adults with MMD. Older age (P < 0.01), posterior cerebral artery (PCA) involvement (P < 0.01), and cerebral blood flow (CBF) impairment (P = 0.02) were significantly associated with a large number of EPVSs. The number of EPVSs markedly decreased at 3months and 2years after surgery compared with that before surgery (P < 0.01). PCA involvement (P = 0.04) and CBF impairment (P = 0.02) were independent predictors of the regression of EPVSs after surgery. The number of EPVSs in the centrum semiovale was closely associated with age, PCA involvement, and CBF impairment in adult patients with MMD, which remarkably regressed after surgical revascularization, especially in the hemispheres with PCA involvement and CBF impairment. EPVSs are reversible radiological markers reflecting impaired cerebral hemodynamics in adult patients with MMD.

Photobiomodulation therapy to prevent oral mucositis and functional impairment in adult patients with haematological cancer undergoing haematopoietic stem cell transplantation: randomised trial protocol

IntroductionOral mucositis is a highly prevalent condition in individuals treated for haematological neoplasms, primarily during haematopoietic stem cell transplantation (HSCT). The condition is known to delay recovery processes, increasing the...

Intellectual Disabilities and Neurocognitive Impairment in Adult Patients with Inherited Metabolic Diseases: A UK Single Centre Experience.

Inherited metabolic diseases (IMDs) are a group of heterogeneous genetic disorders resulting in substrate accumulation, energy deficiency, or complex molecular defects due to the failure of specific molecules to act as enzymes, cofactors, transporters, or receptors in specific metabolic pathways. The pathophysiological changes seen in IMDs are sometimes associated with intellectual disability (ID) or neurocognitive decline, necessitating multidisciplinary input. We here describe our experience at one tertiary metabolic centre in the UK. We reviewed the case prevalence and existing service provision in one adult IMD service covering a multi-ethnic population of 10 million in North England. In our cohort of 2268 IMD patients, 1598 patients had general metabolic conditions (70.5%), and 670 had lysosomal storage disease/disorders (LSD)s (29.5%). The overall prevalence of ID and neurocognitive decline was found to be 15.7% (n = 357), with patients with LSDs accounting for 23.5% (n = 84) of affected patients. Given the prevalence of ID in adults with IMDs, access to multidisciplinary input from neuropsychology and neuropsychiatry services is important. Education of healthcare professionals to diagnose IMDs in patients with ID, in addition to neurocognitive and neuropsychiatric presentations, will avoid missed diagnoses of IMD and will have a positive effect on patient outcomes.

Causes of Visual Impairment in a Sample of Adult Iraqi Patients

Purpose: To identify causes of visual impairment in adult patients seeking treatment at teaching hospital in Iraq. Study Design: Descriptive observational. Place and Duration of Study: Ibn Al-Haytham Teaching Eye Hospital (IAHTEH) in Baghdad, Iraq during the year 2023. Methods: This study comprised of 125,804 adults. All the participants had comprehensive history and ocular examination. Mild, moderate and sever visual impairment were defined as from 6/9 to 6/18, 6/24 to 6/36 and 6/60 or below respectively. Results: Among 125,804 patients, the breakdown of conditions was as follows: 60,650 (48%) had cataracts, 37,741 (30%) had refractive errors, 12,071 (10%) had diabetic retinopathy, 8,328 (7%) had glaucoma, and 7,014 (5%) had experienced trauma. Most patients (54%) had severe visual impairment, followed by moderate (29%) and mild (17%) impairment. The majority of cases (45%) were in individuals aged 60 years and older, with 26% in the 40-59 years age group and 29% in the 20-39 years age group. Diabetic retinopathy was most common in the 40-59 years age group, while glaucoma and cataracts were predominantly in those aged 60 and above. Refractive errors and trauma were mainly found in the 20-39 years age group. Females accounted for 63% of patients with reduced vision, whereas males predominated among trauma cases, with 29% of trauma cases involving blunt trauma. Conclusion: Cataract is the most prevalent condition in older patients. Younger adults frequently experience refractive errors and trauma. Females are more likely to have reduced vision, whereas males are more prone to trauma-related vision issues.

Spectrum of Complex Partial Performance Disorders in Patients with Mental Illnesses

Recent research highlights a high prevalence of minimal cerebral dysfunctions (MCD) in patients with mental disorders. Nonetheless, empirical understanding of minimal cerebral dysfunctions and diffuse neuropsychological impairments in adult patients remains limited. In our study, we examined 399 patients with diverse common mental disorders on minimal cerebral dysfunctions. 329 patients were in psychosomatic rehabilitation, 40 in forensic psychiatry, and 30 in an addiction ward of a psychiatric hospital at the time of the study. Symptom patterns and anamnesis of MCD and sociodemographic characteristics of the patients were recorded using structured questionnaires. Overall, about 29% of all patients reported MCD symptoms. Patients with MCD reported greater problem burden in everyday coping (attention, arithmetic, memory, sensitivity to noise, orientation) and social interaction (outsider, excitability) than patients without partial performance disorders. Patients with mental illness reported a heterogeneous pattern of minimal cerebral dysfunctions. These frequent disorders should be recognized in diagnostics and treatment. Further studies should investigate therapeutic approaches for MCD according to Baltes' Selective Optimization and Compensation model.

Prevalence and Associations of Cognitive Impairment in Adult Patients with Moyamoya Disease: A Systematic Review and Meta-Analysis.

Cognitive impairment, and in the long term Alzheimer's disease, vascular, or mixed dementia, are potential complications of moyamoya disease (MMD), of which the prevalence and associations are not well established. We performed a systematic review and meta-analysis to investigate the prevalence of cognitive impairment in adult patients with MMD as well as its clinical and demographic correlates. We performed a systematic search of four electronic databases: PubMed (MEDLINE), EMBASE, Scopus, and Cochrane Library, profiling studies from inception until 7 May 2023. Clinical data consisting of population characteristics, comorbidities, cognitive assessment tools used, and prevalence of cognitive impairment was extracted. Seventeen studies were included in the meta-analysis, with a total study population of 1,190 patients. All studies assessed cognition, and the overall prevalence of cognitive impairment in MMD patients was 54.59%. A subgroup analysis identified that the prevalence of executive dysfunction in MMD patients was 31.55%. We performed a meta-regression analysis which identified that cognitive impairment was not associated with age, education level, or a history of ischemic or hemorrhagic stroke. A substantial proportion of MMD patients have cognitive impairment, and cognitive impairment was found to have no association with a history of stroke. Further research is necessary to investigate the longitudinal relationship of MMD and cognitive impairment, and the impact of bypass surgery on cognitive impairment.

Phytosterols: Why should we concern about it? Liver impairment in adult patients with parenteral nutrition: Multicenter prospective study

Phytosterols: Why should we concern about it? Liver impairment in adult patients with parenteral nutrition: Multicenter prospective study

Blood biomarkers to detect functional impairment in adult patients with repaired tetralogy of Fallot

BackgroundThe relationship between plasma brain natriuretic peptide (NT-proBNP) and soluble suppression of tumorigenicity-2 (sST2) with structural adaptions and exercise capacity remains incompletely described in patients with repaired Tetralogy of Fallot (rTOF). MethodsPeripheral venous blood samples were drawn for 99 patients with repaired TOF, 59 patients with severe pulmonary regurgitation (PR) and 40 patients with no or mild PR. NT-proBNP was measured using enzyme-linked immunosorbent assays (Roche Diagnostics, Indianapolis, IN). Soluble ST2 levels were assessed on Aspect-plus ST2 quantitative rapid test. ResultsThe mean value of NT-proBNP was 160 ± 137 pg/ml, and sST2 was 29 ± 13, ng/ml in the entire population. 58 % had an elevated NT-proBNP, while sST2 was abnormal in 40 %. Mean NT-proBNP was significantly higher in patients with severe PR (169 ± 150 vs145 ± 118, pg/ml, p < 0.001), while similar sST2 levels were observed in both groups (29 ± 14 vs30 ± 12, ng/ml, p > 0.05). NT-proBNP and sST2 levels were higher in patients with transannular patch when compared to other RVOT intervention (174 ± 145 vs 107 ± 100, pg/ml, p < 0.001); (31 ± 13 vs 29 ± 15, ng/ml, p < 0.05). Both biomarkers were significantly associated with exercise capacity, but NT-proBNP (r = −0.60, p < 0.001) was stronger. The optimal cut-off of 90 pg/ml for NT-proBNP had a sensitivity of 74 % and specificity of 63 % for detection of impaired exercise capacity. ConclusionsSerum levels of sST2 and NT-proBNP are elevated in patients with repaired TOF, with higher values observed in those with severe PR, but also in patients undergoing transannular patch repair. Incorporating both markers in these patients increased the ability to detect impairment in exercise capacity.

Factors Predicting Quality of Life Impairment in Adult Patients with Atopic Dermatitis: Results from a Patient Survey and Machine Learning Analysis.

Atopic dermatitis (AD) is a chronic, inflammatory skin disorder that impairs patients' quality of life (QoL). Physician assessment of AD disease severity is determined by clinical scales and assessment of affected body surface area (BSA), which might not mirror patients' perceived disease burden. Using data from an international cross-sectional web-based survey of patients with AD and a machine learning approach, we sought to identify disease attributes with the highest impact on QoL for patients with AD. Adults with dermatologist-confirmed AD participated in the survey between July-September 2019. Eight machine learning models were applied to the data with dichotomised Dermatology Life Quality Index (DLQI) as the response variable to identify factors most predictive of AD-related QoL burden. Variables tested were demographics, affected BSA and affected body areas, flare characteristics, activity impairment, hospitalisation and AD therapies. Three machine learning models, logistic regression model, random forest and neural network, were selected on the basis of predictive performance. Each variable's contribution was computed via importance values from 0 to 100. For relevant predictive factors, further descriptive analyses were conducted to characterise those findings. In total, 2314 patients completed the survey with mean age 39.2years (standard deviation 12.6) and average disease duration of 19years. Measured by affected BSA, 13.3% of patients had moderate-to-severe disease. However, 44% of patients reported a DLQI > 10, indicative of a very large to extremely large impact on QoL. Activity impairment was the most important factor predicting high QoL burden (DLQI > 10) across models. Hospitalisation during the past year and flare type were also highly ranked. Current BSA involvement was not a strong predictor of AD-related QoL impairment. Activity impairment was the single most important factor for AD-related QoL impairment while current extent of AD did not predict higher disease burden. These results support the importance of considering patients' perspectives when determining the severity of AD.

Cognitive Dysfunction in Hypothyroidism

Cognitive function and hypothyroidism are strongly associated, and age-related differences in performance are significant. The association between hypothyroidism and cognitive impairment in adult patients is still debatable, although it is most severe in the fetus and neonatal period, where it is easy to leave lasting sequelae. Current theories postulate that the various age-related manifestations of this cognitive impairment may be linked to the various stages of hypothyroidism during the time-dependent development of the neurological system. Although the precise mechanism is still not entirely understood, it might be connected to immunological factors.

Oswestry Disability Index Scores and the Relationship to Age, Gender and Diagnosis in a Cohort of Patients with Low Back Pain

Background: The Oswestry Disability Index (ODI) is a commonly used patient reported outcome measure for measuring disability and Quality of Life (QOL) impairment in adult patients in both clinical and research practice. Whilst excellent reliability has been demonstrated the effect of variables such as gender and age on ODI scores appear less well reported. Objective: This study explores the relationship between total ODI scores and factors such as age, gender and diagnosis in a group of low back pain patients. Methods: All patients attending a Spinal Assessment Clinic (SAC) completed the ODI questionnaire at their initial appointment. Data was also collected on age, gender and provisional diagnosis. Results: ODI summary scores were available for 573 patients, with non-specific pain (n=444, 77%), lumbar radiculopathy (n=87, 15%) and spinal claudication (n=42, 7%). Only gender was related to ODI score, with females reporting higher ODI scores across all diagnostic categories, although the average difference between male and female scores failed to reach the Minimally Clinically Important Difference in all categories. Conclusions: A patient’s self-reported levels of disability, as measured by the ODI are influenced by their gender more than by their diagnosis or age

Cognitive Impairment in Patients with Immune Thrombocytopenia

Background Immune thrombocytopenia (ITP) is an autoimmune condition characterized by a low platelet count (<100 x 109/L). Patients with ITP have an increased risk of bruising and bleeding (mainly skin and mucosal). A study by Cooper et al published in 2020 showed that 43% of adult ITP patients have occult cerebral microbleeds (CMBs) on susceptibility-weighted magnetic resonance imaging (SW-MRI). The clinical and prognostic significance of CMBs has not been established but some studies have shown they are associated with cognitive impairment. ITP was believed to be an isolated blood disease, but more recent studies demonstrate impaired quality of life with symptoms including fatigue, memory and concentration problems. This may be suggestive of cognitive impairment. There is only one study by Frith et al that has reported cognitive impairment in adult patients with ITP. The findings of this study are important, although cognitive impairment was measured using a self-reported cognitive failures questionnaire, which may be less robust. Aims The primary objectives of the study were to establish the prevalence of cognitive impairment and which cognitive domains are impaired in patients with ITP. The secondary objective was to investigate any link between ITP disease parameters, presence of CMBs and cognitive impairment. Methods Ethical approval was granted by the London-Surrey Borders Health Research Authority (reference number: 13/LO/1365). Patients with ITP who attend the Imperial College Healthcare NHS ITP center and who had a nadir platelet count ≤ 30 x 109/L at any time during their disease course were recruited to the study. Patients underwent cognitive testing using an automated neuropsychological test battery (CANTAB), completion of SMOG (skin, mucosae, organs) bleeding questionnaire, cerebral SW-MRI to identify CMBs and a full blood count. CANTAB is a validated and automated software tool used in clinical practice and research to assess cognitive impairment. Five key cognitive domains (episodic memory, executive function, processing speed, working memory and attention) were assessed using different tasks. Z-scores standardized for age, sex and education level were generated. Based on the z-scores, the patients' cognitive performance was categorized as impaired or not impaired. Clinical data (including date of diagnosis, nadir platelet count, number of ITP treatments received and co-morbidities) was collected from medical records. One sample T-Tests were used for continuous data while Pearson's Chi Square Test and Fisher's Exact Test were used for categorical data. Multiple comparisons corrections were not performed. Results A total of 69 patients completed CANTAB cognitive testing and MRI. The median age was 40 years (range 19-88), median age at diagnosis was 31 years (range 4-83), median duration of disease was 69 months (range 5-535), median nadir platelet count was 5 x 109/L (range 0-30), median platelet count at time of test was 95 x 109/L (range 4-653) and median ITP treatments received were 4 (range 0-14). Forty-six percent of patients had other co-morbidities, 65% were female and 52% of patients were receiving ITP treatment at the time of cognitive testing. Of the 69 patients tested, 50% (95% CI [37, 62]) had at least one impaired cognitive domain (Figure 1a). The percentage of patients with impairment per domain were 22% episodic memory, 19% executive function, 16% processing speed, 13% working memory and 3% attention. Two patients could not finish the episodic memory CANTAB task; therefore, their score for this domain could not be generated. Higher organ bleeding score was associated with impaired episodic memory (p=0.048) (Figure 1b). Older age at diagnosis, age at time of cognitive test and number of ITP treatments received were associated with impaired episodic memory (p=0.03, p=0.08 and p=0.04 respectively). There was no correlation between the presence or number of CMBs and impaired cognition. Conclusion This is the first study to objectively measure cognitive impairment in patients with ITP. It showed that a significant proportion (50%) of patients with ITP suffer from cognitive impairment, with episodic memory being most affected. These results suggest that ITP is not just a 'low platelet' disease. Correlation between ITP disease parameters and impaired cognition requires further investigation in a larger cohort. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Relationship Between Caregiver Burden and Cognitive Impairment in Adult Patients with Type 2 Diabetes

Introduction: Caregivers play a critical role in health management of patients with chronic diseases. Caregiving is associated with experiencing different emotional and psychological problems. Objective: This study aims to determine the relationship between caregiver burden and cognitive function in adult patients with Type 2 Diabetes (T2D). Materials and Methods: In this cross-sectional study, 215 family caregivers of adult patients with T2D were selected by a systematic random sampling method. A socio-demographic form, the Caregiver Burden Inventory (CBI), and the Mini-Mental State Examination (MMSE) were used for data collection. Data were analyzed using Kruskal-Wallis test, Spearman’s rho correlation test. The multinomial logistic regression model was used to examine the power of Cognitive Impairment (CI) in predicting the caregiver burden. P&lt;0.05 was considered as the statistically significance level. Results: The mean age of caregivers and patients were 48±9 and 52±2 years, respectively. The mean score of CBI was 24.57±18.2, indicating a moderate level of caregiver burden. The mean score of MMSE was 25.25±3.6, indicating a mild CI in patients. Caregiver burden showed a significant correlation with cognitive function (r=-0.336, 95% CI; 0.53–0.89, P=0.001) such that the decreased CI was associated with an increase in total caregiver burden (r=-0.348, 95% CI; 0.43–0.87, P=0.001). The regression results showed that the CI levels were not predictors of caregiver burden severity. Conclusion: The CI of patients with T2D may affect their caregivers’ burden. Therefore, assessing the cognitive function of these patients can help healthcare providers conduct interventions to enhance the caregivers’ quality of life.

Clinical Evaluation of Exertional Dyspnea in Adult Pectus Excavatum Patients

Abstract: Evaluation of patients with pectus excavatum has primarily been focused and, especially the pediatric population who undergoes surgical correction of sternal defects mainly for cosmetic reasons combined with exercise-limiting symptoms. The extent of cardiopulmonary improvement in this population based on cardiac imaging, pulmonary function testing, and cardiopulmonary exercise testing may be highly variable. There is no current consensus on the limitations of cardiopulmonary impairment or potential improvement from surgical repair in pediatric patients. Limited data have been published in the medical literature on the evaluation of adults with pectus excavatum who may also present with a variety of clinical symptoms. Adult patients with exercise limitation and pectus excavatum may present with exertional dyspnea, chest discomfort, palpitations/tachycardia, exercise-induced wheezing, and use of bronchodilators for asthma-like symptoms. While numerous published review articles outline clinical evaluation and surgical treatment for younger patients, comprehensive evaluation for these adult patients has not been fully elucidated. There is no current consensus on the underlying cause of cardiopulmonary impairment in adult patients or their potential improvement from surgical repair. This review focuses on the recommended evaluation of adult patients to discern the potential cardiopulmonary limitations to exercise due to pectus excavatum, especially in physically fit adults, such as active-duty military personnel. Two illustrative cases are presented to describe the complexity of the evaluation for adult patients and the potential need for surgical correction.

Cognitive Impairment in Adult Patients with 5q-Associated Spinal Muscular Atrophy.

In previous studies, a below-average, average, or above-average intelligence quotient (IQ) in children with SMA was detected but, aside from a severe physical disability, the cognitive performance of adult SMA patients has not yet been evaluated. The intelligence test used in this study, the Wechsler Adult Intelligence Scale, fourth edition (WAIS-IV), was used to measure major intelligence components of adult SMA patients. The WAIS-IV determines four index scores representing verbal comprehension, perceptual reasoning, working memory, and processing speed. Due to time-dependent demands on motor function, the processing speed index score was excluded. IQ index scores of 33 adult SMA patients did not differ from IQ index scores of the normal population. In SMA type-3 patients, the index scores for verbal comprehension, perceptual reasoning, and working memory did not differ from the normal population but showed a trend of IQ scores towards lower points. Patients with SMA type 2 had lower IQ index scores for working memory (90.33 ± 12.95; p = 0.012) and perceptual reasoning (90.73 ± 12.58; p = 0.013) than the normal population. This study provided further evidence that SMA is a multi-systemic disease and may refute the widespread hypothesis that SMA patients might improve their cognitive skills to compensate for their physical impairment.

Assessment of hearing impairment in adult patients with euthyroid Hashimoto’s thyroiditis

Assessment of hearing impairment in adult patients with euthyroid Hashimoto’s thyroiditis

The impact of error of refraction and retinal nerve fiber layer thickness on cognitive functions in adults with bilateral myopia

Objective Myopia is considered one of the main causes of visual impairment with increased prevalence. The main objective of this study was to evaluate and characterize cognitive impairment in adult patients with bilateral myopia, in relation to retinal nerve fiber layer (RNFL) thickness. Methods Forty patients with bilateral myopia aged 18–40 years, and 40 age- and gender-matched healthy controls were included in the study. For all subjects, cognitive functions were assessed by Paced Auditory Serial Addition Test (PASAT) and Paired Associate Learning test (PALT). Optical coherence tomography (OCT) was done for all included patients and controls. Results Among the myopic group, 15 patients had mild myopia, 8 patients had moderate myopia and 17 patients had high myopia. There were significant differences between patients and control groups in terms of cognitive performance and RNFL thickness. There was a significant correlation between the scores of cognitive tests and error of refraction and RNFL thickness. Conclusion Adults with bilateral myopia have cognitive impairment, regarding information processing speed and episodic memory. Cognitive impairment is associated with retinal thinning and a higher degree of myopia.

Risk Factors for Renal Impairment in Adult Patients With Short Bowel Syndrome.

Renal impairment is a common complication in patients with intestinal failure that is mostly caused by short bowel syndrome (SBS) and is associated with adverse outcomes that severely affect the quality of life or even survival. The prevalence and risk factors for renal impairment in patients with SBS remain unclarified. Therefore, we aimed to determine the prevalence of renal impairment and identify potential risk factors for renal impairment in adult patients with SBS. We retrospectively identified 199 patients diagnosed with SBS admitted to the Department of General Surgery between January 1, 2012 and January 1, 2019, from a prospectively maintained database. Overall, 56 patients (28.1%) with decreased renal function (eGFR < 90 mL/min/1.73 m2). The median duration of SBS was 7 months (IQR, 3–31 months) and the mean eGFR was 103.1 ± 39.4 mL/min/1.73 m2. Logistic regression modeling indicated that older age [odds ratio (OR), 1.074; 95% CI, 1.037–1.112, P < 0.001], kidney stones (OR, 4.887; 95% CI, 1.753–13.626; P = 0.002), decreased length of the small intestine (OR, 0.988; 95% CI, 0.979–0.998; P = 0.019), and prolonged duration of SBS (OR, 1.007; 95% CI, 1.001–1.013; P = 0.046) were significant risk factors for renal impairment. This is the largest study that has specifically explored the risk factors for renal impairment in a large cohort of adults with SBS. The present study showed that renal function should be closely monitored during treatment, and patients should be given prophylactic interventions if necessary. This retrospective study is a part of clinical study NCT03277014, registered in ClinicalTrials.gov PRS. And the PRS URL is http://register.clinicaltrials.gov.

Functional independence and spirometry in adult post-intensive care unit patients.

ObjectiveTo relate functional independence to the degree of pulmonary impairment in adult patients 3 months after discharge from the intensive care unit.MethodsThis was a retrospective cohort study conducted in one adult intensive care unit and a multi-professional post-intensive care unit outpatient clinic of a single center. Patients admitted to the intensive care unit from January 2012 to December 2013 who underwent (3 months later) spirometry and answered the Functional Independence Measure Questionnaire were included.ResultsPatients were divided into groups according to the classification of functional independence and spirometry. The study included 197 patients who were divided into greater dependence (n = 4), lower dependence (n = 12) and independent (n = 181) groups. Comparing the three groups, regarding the classification of the Functional Independence Measure, patients with greater dependence had higher Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment values at intensive care unit admission with more advanced age, more days on mechanical ventilation, and longer stay in the intensive care unit and hospital. The majority of patients presented with pulmonary impairment, which was the obstructive pattern observed most frequently. When comparing functional independence with pulmonary function, it was observed that the lower the functional status, the worse the pulmonary function, with a significant difference being observed in peak expiratory flow (p = 0.030).ConclusionThe majority of patients who returned to the outpatient clinic 3 months after discharge had good functional status but did present with pulmonary impairment, which is related to the degree of functional dependence.