Multivariable association of 6-month physical measures with 12-month patient-centred outcomes
| 6-month physical measures | Alive between 6 and 12 months †OR (95% CI) | No hospitalisation between 6 and 12 months‡ OR (95% CI) | Alive at home at 12 months§ OR (95% CI) | SF-36 PCS 12 months β (95% CI) | EQ-5D utility 12 months β (95% CI) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| ICAP | ALTOS | ICAP | ALTOS | ICAP | ALTOS | ICAP | ALTOS | ICAP | ALTOS | |
| N=99 | N=134 | N=81 | N=125 | N=94 | N=133 | N=90 | N=124 | N=91 | N=125 | |
| Body structure and function | ||||||||||
| FEV1, each 10% predicted¶ | 2.47 (0.90 to 6.81) | 0.50 (0.23 to 1.08) | 0.76 (0.54 to 1.05) | 1.26 (0.97 to 1.63) | 2.25 (1.10 to 4.59)* | 0.63 (0.41 to 0.97)* | 0.39 (−0.71 to 1.49) | 0.60 (−0.49 to 1.70) | −0.69 (−2.81 to 1.42) | 0.17 (−1.90 to 2.24) |
| % muscle area, each 10% | 0.64 (0.11 to 3.85) | 1.25 (0.75 to 2.09) | 0.77 (0.50 to 1.20) | 0.92 (0.69 to 1.22) | 0.41 (0.12 to 1.42) | 1.07 (0.77 to 1.48) | 1.56 (−0.01 to 3.14) | −0.99 (−2.14 to 0.15) | 2.36 (−0.67 to 5.39) | −1.84 (−4.01 to 0.33) |
| MIP, each 10% predicted | 1.21 (0.58 to 2.51) | 1.35 (0.92 to 1.98) | 1.01 (0.85 to 1.20) | 0.93 (0.79 to 1.09) | 0.85 (0.57 to 1.29) | 1.19 (0.95 to 1.49) | −0.14 (−0.75 to 0.47) | 0.35 (−0.34 to 1.04) | −0.52 (−1.69 to 0.66) | 0.75 (−0.56 to 2.05) |
| MMT, each 10% max MRC score | 0.56 (0.11 to 2.89) | 0.48 (0.06 to 3.56) | 0.96 (0.44 to 2.10) | 1.06 (0.51 to 2.24) | 1.01 (0.29 to 3.50) | 1.54 (0.61 to 3.87) | 2.25 (−0.19 to 4.70) | 2.25 (−0.87 to 5.36) | −1.41 (−6.07 to 3.25) | 9.03 (3.13 to 14.93)** |
| Grip strength, each 10% predicted | 0.96 (0.51 to 1.83) | 0.93 (0.61 to 1.43) | 1.36 (0.98 to 1.88) | 0.93 (0.76 to 1.15) | 1.04 (0.65 to 1.68) | 0.94 (0.70 to 1.26) | −0.96 (−1.88 to −0.03) | −0.79 (−1.63 to 0.05) | −2.05 (−3.84 to −0.27) | −0.97 (−2.56 to 0.62) |
| Activity | ||||||||||
| 6 min walk, each 10% predicted | 0.56 (0.22 to 1.46) | 1.31 (0.71 to 2.39) | 1.36 (0.98 to 1.87) | 1.11 (0.81 to 1.51) | 0.69 (0.35 to 1.36) | 1.21 (0.85 to 1.71) | 1.73 (0.64 to 2.83)** | 1.13 (−0.06 to 2.33) | 2.31 (0.20 to 4.42)* | 0.51 (−1.73 to 2.75) |
| 4 m gait speed (per 0.11 m/s)‡‡ | – | 0.78 (0.54 to 1.13) | – | 1.22 (0.94 to 1.58) | – | 0.81 (0.64 to 1.03) | – | 0.70 (−0.12 to 1.52) | – | 0.79 (−0.77 to 2.35) |
| Participation | ||||||||||
| No. ADL dependencies (ICAP only) | 0.62 (0.15 to 2.54) | – | 0.89 (0.50 to 1.57) | – | 0.83 (0.25 to 2.74) | – | 1.05 (−1.35 to 3.44) | – | 0.65 (−3.96 to 5.25) | – |
| No. IADL dependencies (ICAP only) | 0.41 (0.19 to 0.91)* | – | 1.50 (1.02 to 2.20)* | – | 0.54 (0.31 to 0.96)* | – | −1.32 (−2.40 to −0.24)* | – | −2.89 (−4.96 to −0.81)** | – |
| FPI––total, per 0.20 unit (ALTOS only)§§ | – | 1.05 (0.71 to 1.55) | – | 1.04 (0.86 to 1.25) | – | 1.17 (0.90 to 1.53) | – | 1.51 (0.72 to 2.29)** | – | 2.00 (0.52 to 3.49)** |
| Model fit; variance explained†† | AUC=0.95 | AUC=0.83 | AUC=0.74 | AUC=0.71 | AUC=0.91 | AUC=0.78 | R2=0.27 | R2=0.34 | R2=0.15 | R2=0.23 |
* p≤0.05; ** p≤0.01; ‘–’, measure not available in dataset.
†Alive between 6 and 12 months (yes=1, 0=no; ICAP––1, n=95, 96%; 0, n=4, 4%; ALTOS––1, n=129, 96%; 0, n=5, 4%).
‡No hospitalisation between 6 and 12 months (yes=1, 0=no; ICAP––1, n=59, 73%; 0, n=22, 27%; ALTOS––1, n=98, 78%; 0, n=27, 22%).
§Alive at home outcome for 12 months (yes=1, 0=no; ICAP––1, n=88, 94%, 0, n=6, 6%; ALTOS––1, n=120, 90%; 0, n=13, 10%).
¶FEV1 at 6 months for ICAP has missing values imputed using 3-month values; No imputation of FEV1 values was performed for ALTOS.
††Model discrimination is based on area under the receiver operating characteristic for survival, hospitalization, alive at home status and R2 for SF-36 PCS and EQ-5D utility.
‡‡0.11 m/s is an estimated MCID for the 4 m gait speed test based on prior study among patients with COPD.31
§§0.20 is an estimated MCID for the FPI. There was no evidence of multicollinearity (variance inflation factor ≤1.59 for independent variables estimated within each models).
ADL, activities of daily living; ALTOS, ARDSNet Long-Term Outcome Study; AUC, area under the curve; EQ-5D, Euro-QOL; FPI, Functional Performance Inventory; IADL, instrumental activities of daily living; ICAP, Improving Care of Acute Lung Injury Patients; MCID, minimal clinically important difference; MIP, maximal inspiratory pressure; MMT, manual muscle testing; MRC, Medical Research Council; QOL, Quality of Life; SF-36 PCS, Medical Outcomes Study Short-Form 36 physical component score.