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Care of the older person
Prehospital physical function and strength can influence clinical outcomes of critically ill older adults
  1. David Mcwilliams
  1. Therapy Services, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Mr David Mcwilliams, Therapy Services, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; david.mcwilliams{at}

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Commentary on: Files DC, Neiberg R, Rushing J, et al. Influence of prehospital function and strength on outcomes of critically ill older adults. J Am Geriatr Soc 2018;66:525–531.

Implications for practice and research

  • From a clinical perspective, a greater understanding of the link between baseline functional status and outcomes in patients developing critical illness will help identify those at high risk and most in need of targeted rehabilitation strategies.

  • From a research point of view, a greater insight into this relationship would help to provide perspective on long-term functional outcomes in survivors of critical illness.


The importance of the relationship between preadmission functional status and long-term outcomes for critically ill patients is being increasingly recognised. Despite this, current commonly used critical care illness severity scores fail to account for baseline physical function that may limit their overall ability to predict clinical outcomes. This study by Files and …

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  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.