Authors (including presenting author) :
Chan WY(1), Lam KN(2), Tsang HC(1), Lee KW(1), Lui SR(1), Tang PY(2), Yeung WY(2), To YL(1), Sun TF(3)
Affiliation :
(1)Physiotherapy Department, (2)Intensive Care Unit, (3)Hospital Chief Executive Office, North District Hospital
Introduction :
Mobilization is part of the physiotherapy interventions for patients with critical illness. Since early mobilization (EM) has been reported to improve functional recovery and shorten hospital stay, EM was implemented in a 14-bed intensive care unit (ICU) since late 2017 and the practice was reviewed in 2020.
Objectives :
To compare the effectiveness of EM against usual care for ICU patients.
Methodology :
This was a retrospective cohort study with a control group (patients with usual care in 2017) and an intervention group (patients with EM in 2020). Data were retrieved from April to October in 2017 and compared with that in the same period in 2020. Demographics and baseline data included age, gender, ICU mobility scale (ICUMS) on admission and ICU physiotherapy attendance. Outcome measures included ICUMS upon discharge, length of stay (LOS) in ICU and hospital (after discharged from ICU), ventilator days and mortality rate. Standard descriptive statistics were used to summarize patients’ characteristics. Data were processed using Mann-Whitney U test, Wilcoxon Signed Rank Test and Chi-square.
Result & Outcome :
Results:
There were 136 (66.9% male, 33.1% female) and 148 (64.9% male, 35.1% female) patients in the control and intervention group respectively. The mean age was 63.31 in control group and 64.48 in intervention group. The baseline median ICUMS were 1 in both groups. All these variables were comparable between groups with p>0.05.
Both groups received similar treatment attendances (control: 5.38, intervention: 5.42, p=0.152). There was significant increase in ICUMS from a median of 1 to 5 (p< 0.001) in the intervention group whereas no significant change was noted in the control group. There was no significant inter-group difference in ICU LOS (control: 6.62 days, intervention: 7.12 days) and ventilator days (control: 4.35 days, intervention: 4.86 days). Post-ICU LOS was shorter in the intervention group (mean= 12.85 days) as compared to the control group (mean= 23.37 days) and the mortality rate appeared higher in the control group (15.4%) than the intervention group (10.8%), though both differences were also not statistically significant.
Conclusions:
EM enhanced the mobility of ICU patients upon discharge and the early intervention may account for this improvement which is independent of the ICU LOS and treatment intensity.
