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Editor's Note |

The Critical Importance of Functional Status in Critical Illness

Kenneth E. Covinsky, MD, MPH
JAMA Intern Med. 2015;175(4):530. doi:10.1001/jamainternmed.2014.7897.
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When patients are in an intensive care unit (ICU), considerable attention is placed on physiological variables of illness. This novel article by Ferrante and colleagues1 establishes that we also need to be attentive to patient-centered measures of function as a fundamental measure of illness that must be assessed in all older ICU patients. The need for assistance before admission with basic functional tasks such as bathing, taking medicines, and preparing meals was a powerful predictor of 30-day and 1-year survival. Those with severe premorbid disability were at more than 3 times the risk of dying by 1 year as those with minimal to mild disability (68% vs 19%). Functional status was as important a risk factor as shock or the need for mechanical ventilation.

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