Use of actigraphy to characterize inactivity and activity in patients in a medical ICU
Use of actigraphy to characterize inactivity and activity in patients in a medical ICU
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DOI：
10.1016/j.hrtlng.2020.02.002
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发表时间：
2020-07-01
期刊：
影响因子：
2.8
通讯作者：
Kamdar, Biren B.
中科院分区：
文献类型：
--
作者：
Gupta, Prerna;Martin, Jennifer L.;Kamdar, Biren B.
背景：在重症监护病房（ICU），不活动是常见的，有助于ICU获得性虚弱和不良结局。腕动记录仪可能是有用的测量活动在ICU.Objectives：使用腕动记录仪来表征不活动和活动在危重病patients.Methods：这项前瞻性观察性研究涉及48小时手腕腕动记录仪在医疗ICU（MICU）患者，活动数据捕获在30秒的时代。总结了关键患者的无活动（零活动时期）和活动（非零活动水平）（例如，年龄）和临床（例如，结果：在34名MICU患者中，总共收集了189，595个30-s时间点。零活动（不活动）包括122，865（65%）个时期;这些时期在接受机械通气的患者（与无，p < 0.001）和最高（与最低）器官衰竭评分三分位数（p = 0.03）中分别高出24%和13%。能走动的患者（与不能走动的患者相比）表现出更多的非零活动（每个时期多35次运动，p < 0.001），而器官衰竭评分最高（与最低）的三分位数患者表现出较少的活动（每个时期少22次运动，p = 0.03）。显着的不活动/活动差异时，没有观察到基于年龄，镇静，或约束status.Conclusions：活动记录表明，MICU患者是深刻的不活动，包括那些谁是年轻的，非镇静和非约束。因此，ICU特定的非患者相关因素可能导致不活动，这是一个需要进一步调查的问题。爱思唯尔公司出版
Background: In the intensive care unit (ICU), inactivity is common, contributing to ICU-acquired weakness and poor outcomes. Actigraphy may be useful for measuring activity in the ICU.Objectives: To use actigraphy to characterize inactivity and activity in critically ill patients.Methods: This prospective observational study involved 48-h wrist actigraphy in medical ICU (MICU) patients, with activity data captured across 30-s epochs. Inactivity (zero-activity epochs) and activity (levels of non-zero activity) were summarized across key patient (e.g., age) and clinical (e.g., mechanical ventilation status) variables, and compared using multivariable regression.Results: Overall, 189,595 30-s epochs were collected in 34 MICU patients. Zero-activity (inactivity) comprised 122,865 (65%) of epochs; these epochs were 24% and 13% more prevalent, respectively, in patients receiving mechanical ventilation (versus none, p < 0.001) and in the highest (versus lowest) organ failure score tertile (p = 0.03). Ambulatory (versus non-ambulatory) patients exhibited more non-zero activity (35 more movements per epoch, p < 0.001), while those in the highest (versus lowest) organ failure score tertile exhibited less activity (22 fewer movements per epoch, p = 0.03). Significant inactivity/activity differences were not observed when evaluated based on age, sedation, or restraint status.Conclusions: Actigraphy demonstrated that MICU patients are profoundly inactive, including those who are young, non-sedated and non-restrained. Hence, ICU-specific, non-patient-related factors may contribute to inactivity, an issue requiring further investigation. Published by Elsevier Inc.