• Crit Care · Jul 2024

    Early physical rehabilitation dosage in the intensive care unit associates with hospital outcomes after critical COVID-19.

    • Kirby P Mayer, Evan Haezebrouck, Lori M Ginoza, Clarisa Martinez, Minnie Jan, Lori A Michener, Lindsey E Fresenko, Ashley A Montgomery-Yates, Anna G Kalema, Amy M Pastva, Michelle Biehl, Matthew F Mart, and Joshua K Johnson.
    • Department of Physical Therapy, College of Health Sciences, University of Kentucky, 900 Rose Street, Lexington, KY, 40536, USA. Kpmaye2@uky.edu.
    • Crit Care. 2024 Jul 18; 28 (1): 248248.

    ObjectiveTo examine the relationship between physical rehabilitation parameters including an approach to quantifying dosage with hospital outcomes for patients with critical COVID-19.DesignRetrospective practice analysis from March 5, 2020, to April 15, 2021.SettingIntensive care units (ICU) at four medical institutions.Patientsn = 3780 adults with ICU admission and diagnosis of COVID-19.InterventionsWe measured the physical rehabilitation treatment delivered in ICU and patient outcomes: (1) mortality; (2) discharge disposition; and (3) physical function at hospital discharge measured by the Activity Measure-Post Acute Care (AM-PAC) "6-Clicks" (6-24, 24 = greater functional independence). Physical rehabilitation dosage was defined as the average mobility level scores in the first three sessions (a surrogate measure of intensity) multiplied by the rehabilitation frequency (PT + OT frequency in hospital).Measurements And Main ResultsThe cohort was a mean 64 ± 16 years old, 41% female, mean BMI of 32 ± 9 kg/m2 and 46% (n = 1739) required mechanical ventilation. For 2191 patients who received rehabilitation, the dosage and AM-PAC at discharge were moderately, positively associated (Spearman's rho [r] = 0.484, p < 0.001). Multivariate linear regression (model adjusted R2 = 0.68, p < 0.001) demonstrates mechanical ventilation (β = - 0.86, p = 0.001), average mobility score in first three sessions (β = 2.6, p < 0.001) and physical rehabilitation dosage (β = 0.22, p = 0.001) were predictive of AM-PAC scores at discharge when controlling for age, sex, BMI, and ICU LOS.ConclusionsGreater physical rehabilitation exposure early in the ICU is associated with better physical function at hospital discharge.© 2024. The Author(s).

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