Relationship of Age And Mobility Levels During Physical Rehabilitation With Clinical Outcomes in Critical Illness.
Relationship of Age And Mobility Levels During Physical Rehabilitation With Clinical Outcomes in Critical Illness.
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DOI：
10.1016/j.arrct.2023.100305
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发表时间：
2023-12
影响因子：
--
通讯作者：
中科院分区：
文献类型：
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确定年龄、活动水平以及前 3 次身体康复疗程中活动水平的变化是否与危重患者的临床结果相关。回顾性、观察性队列研究。医疗重症监护病房（MICU）。在 MICU 接受 3 次或以上连续康复治疗的住院成人 (n=132)。不适用。样本包括 132 名患者，其中 60 名 (45%) 为年轻患者（18-59 岁），72 名患者（55%）为老年患者（60 岁以上）。最常见的诊断是脓毒症/败血症（32.6%）。相对于年轻患者，老年患者在整个康复过程中 ICU 活动量表 (IMS) 评分的改善速度明显较慢（平均斜率系数 0.3 比 0.6 分，P<.001），出院回家的可能性较小（30.6% 比 55.0%，P=.005），并且更有可能在 12 个月内死亡（41.7% 比 25.0%，P=.046）。协变量调整模型表明 IMS 评分的早期改善与出院回家相关 (P=.005)。首次康复时间较长、初始 IMS 评分较低以及 IMS 评分改善较慢与 ICU 天数增加相关（所有 P<.03）。年龄较大、未达到坐在床边的活动里程碑或跨疗程活动进展有限与患者预后不佳有关。我们的研究结果表明，年龄和活动水平有助于结果预测，并有助于临床表型和康复服务分配。
To determine whether age, mobility level, and change in mobility level across the first 3 physical rehabilitation sessions associate with clinical outcomes of patients who are critically ill. Retrospective, observational cohort study. Medical Intensive Care Unit (MICU). Hospitalized adults (n = 132) who received 3 or more, consecutive rehabilitation sessions in the MICU. Not applicable. Sample included 132 patients with 60 (45%) classified as younger (18-59 years) and 72 (55%) as older (60+ years). The most common diagnosis was sepsis/septicemia (32.6%). Older relative to younger patients had a significantly slower rate of improvement in ICU Mobility Scale (IMS) scores across rehabilitation sessions (mean slope coefficient 0.3 vs 0.6 points, P<.001), were less likely to be discharged to home (30.6% vs 55.0%, P=.005), and were more likely to die within 12 months (41.7% vs 25.0%, P=.046). Covariate-adjusted models indicated greater early improvement in IMS scores were associated with discharge home (P=.005). Longer time to first rehabilitation session, lower initial IMS scores, and slower improvement in IMS scores were associated with increased ICU days (all P<.03). Older age and not achieving the mobility milestone of sitting at edge of bed or limited progression of mobility across sessions is associated with poor patient outcomes. Our findings suggest that age and mobility level contribute to outcome prognostication, and can aide in clinical phenotyping and rehabilitative service allocation.
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影响因子：
1.9
作者：
Hajeb M;Singh TD;Sakusic A;Graff-Radford J;Gajic O;Rabinstein AA
通讯作者：
Rabinstein AA
影响因子：
9.6
作者：
Calvo-Ayala, Enrique;Khan, Babar A.;Boustani, Malaz A.
通讯作者：
Boustani, Malaz A.
DOI：
10.1186/s13054-014-0658-y
发表时间：
2014-12-04
期刊：
Critical care (London, England)
影响因子：
--
作者：
Hodgson CL;Stiller K;Needham DM;Tipping CJ;Harrold M;Baldwin CE;Bradley S;Berney S;Caruana LR;Elliott D;Green M;Haines K;Higgins AM;Kaukonen KM;Leditschke IA;Nickels MR;Paratz J;Patman S;Skinner EH;Young PJ;Zanni JM;Denehy L;Webb SA
通讯作者：
Webb SA
影响因子：
8.8
作者：
Devlin, John W.;Skrobik, Yoanna;Alhazzani, Waleed
通讯作者：
Alhazzani, Waleed
影响因子：
15.1
作者：
Hill, A. D.;Fowler, R. A.;Scales, D. C.
通讯作者：
Scales, D. C.