Factors that may affect functional recovery after critical illness

Claire Tipping's research examines some of the factors that may affect functional recovery after critical illness and includes the following studies:

Systematic Review

A systematic review of the published literature assessing the effect of early rehabilitation and mobilisation on patients mechanically ventilated in ICU compared to standard care. The review found that active mobilisation and rehabilitation in the ICU does not impact short and long term mortality, but may improve mobility status, muscle strength and days alive and out of hospital to 180 days.

Claire Tipping

Observational Studies assessing the clinimetric properties of the ICU mobility scale (IMS)

A prospective observational study (n=192) finds that the IMS is valid and responsive in an ICU population and helps to confirm the usability of this scale as an outcome in ICU patients.

A prospective observational study (n=184) calculating the minimal important difference of the IMS in critically ill ICU patients found that a change of 1.4-3 on the IMS is considered clinically significant.

Observational Studies assessing the impact of frailty in trauma ICU patients.

A prospective observational study (n=100) demonstrating that measuring frailty in a trauma ICU population is feasible, with excellent correlation between two frailty measures (Frailty Phenotype and Clinical Frailty Scale). Both showed aspects of construct and predictive validity; however, the FP might be more clinically relevant in this population.

This prospective observational study (n=138) found that 22% of patients were frail on the Frailty Phenotype in a trauma ICU population. Frailty was independently associated with mortality at 6 and 12 months and frail patients had poorer global function (GOS-E) and poorer health rated quality of life (EQ-5D-5L utility score) at six and 12 months, compared to patients who were not frail. This is despite patients with frailty being significantly less injured (ISS), having lower rates of operations and mechanical ventilation and being more mobile on discharge from ICU. Patients with frailty were however older, had more co-morbidities and higher APACHE II scores.

Contact: For further information, please contact Claire Tipping by email.