著者
Shinichi Watanabe Keibun Liu Yasunari Morita Takahiro Kanaya Yuji Naito Shuichi Suzuki Yoshinori Hasegawa
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.7, pp.20220013, 2022 (Released:2022-03-23)
参考文献数
48
被引用文献数
3

Objectives: This study investigated the effect of early mobilization [EM; physical rehabilitation with the intensity needed to sit on the edge of the bed started within 5 days of intensive care unit (ICU) admission] in relation to improvements in gait independence and other clinical outcomes.Methods: This retrospective single-center study evaluated patients aged at least 18 years who stayed in the ICU for at least 48 h and were categorized into EM and late mobilization (LM; physical rehabilitation started more than 5 days after ICU admission) groups. Outcomes were compared after adjusting for 20 background factors by propensity score matching and inverse probability of treatment weighting. The primary outcome was independent gait at discharge. The secondary outcomes were medical costs, 90-day survival, and durations of ICU and hospital stays.Results: Of 177 patients, 85 and 92 were enrolled in the EM and LM groups, respectively. Propensity score matching created 37 patient pairs. There was no significant difference in the 90-day survival rate (P=0.308) or medical costs (P=0.054), whereas independent gait at discharge (P=0.025) and duration of hospital stay (P=0.013) differed significantly. Multivariate logistic regression analysis showed that EM was independently associated with independent gait at discharge (P=0.011) and duration of hospital stay (P=0.010) but was not associated with 90-day survival (odds ratio: 2.64, 95% confidence interval: 0.67–13.12, P=0.169).Conclusions: Early mobilization in the ICU did not affect 90-day survival and did not lower medical costs but was associated with independent gait at discharge and shorter hospital stays.

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https://t.co/lHHvCYSfWU 早期離床群では離床遅延群(ICU入室から平均5日目)と比較して退院時歩行自立、入院期間短縮との関連を認めた。 90日死亡率や医療費との関連を認めなかった。 早期離床と死亡率との関連は認めない報告が多いですね。 入院期間短縮を認めるのに医療コストは変わらないのか。
Effects of Mobilization among Critically Ill Patients in the Intensive Care Unit: A Single-center Retrospective Study https://t.co/JHkIgthamH #icurehab #A2Fbundle

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