Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
REHABILITATION
Bed rest, COVID-19, Critical care, Early ambulation, Intensive care units, Mobilisation, Physical therapy specialty, SARS-CoV-2
Anestesi och intensivvård
INTENSIVE-CARE-UNIT
POINT-PREVALENCE
Bed rest; COVID-19; Critical care; Early ambulation; Intensive care units; Mobilisation; Physical therapy specialty; SARS-CoV-2
SOCIETY
610
GUIDELINES
THERAPY
Bed rest
Early ambulation
Bed rest; COVID-19; Critical care; Early ambulation; Intensive care units; Mobilisation; Physical therapy specialty; SARS-CoV-2;
Medicine and Health Sciences
Physical therapy specialty
Intensive care unit
Mobilisation
Intensive care units
Anesthesiology and Intensive Care
SARS-CoV-2
RC86-88.9
Research
Intensive Care - Radboud University Medical Center
COVID-19
Medical emergencies. Critical care. Intensive care. First aid
Health Care Service and Management, Health Policy and Services and Health Economy
VENTILATION
[SDV] Life Sciences [q-bio]
Critical care
TRIALS
ICU
Radboudumc 0: Other Research Intensive Care
DOI:
10.1186/s13613-023-01201-1
Publication Date:
2023-11-14T11:02:28Z
AUTHORS (370)
ABSTRACT
Abstract
Background
Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave.
Methods
This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs.
Results
Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates.
Conclusions
Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility.
Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021).
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CITATIONS (2)
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