Objective: To explore the association of patient or family reported functional deterioration (defined by a single question) in the preceding year, with mortality outcome for those admitted to the Intensive Care Unit (ICU).

Design: Retrospective observational analysis of a routinely collected data source.

Participants: Patients that were admitted to the ICU at Northwick Park Hospital, London North West University Healthcare NHS Trust between 1/10/2017 to 15/6/2019 were included. Patients were excluded if they had a prior ICU admission during the existing hospital episode or if information on functional deterioration could not be retrieved from either the patient or their advocate.

Primary Outcomes: Mortality at the point of hospital discharge and 1 year following admission to the ICU.

Results: Of the 1006 patients who were admitted to the ICU during the study period, information on functional deterioration was available for 621 patients who were included in the analysis. From these, 251 (40.4%) patients had patient or family reported functional deterioration in the preceding year, whilst 370 (59.6%) patients had a perceived stable functional baseline. Comparing the two groups, mortality was significantly higher in those who had functionally deteriorated compared to those with stable baseline function, at the point of hospital discharge (45.4% versus 25.9%; P<0.0001) and at 1 year (59.4% versus 33.0%; P<0.0001). 

Conclusion: Patient or family reported functional deterioration was significantly associated with higher mortality at the point of hospital discharge and at 1 year. The concept of functional deterioration in the lead up to ICU admission warrants further exploration.

Data was collected from routine data sources that comprise of clinical records and local audit data submitted for the Intensive Care Audit and Research Centre (ICNARC) Case Mix Programme (CMP)

Routine data sources of all patients admitted to ICU during study time period. This data also includes those who were excluded from analysis (including patients where functional deteriroation wasn't known and patients who were ICU readmissions during the study period).

We have removed identifiers from this dataset such as hospital admission dates, general demographic data, and other associated social data.