Does the level of mobility on ICU discharge impact post-ICU outcomes? A retrospective analysis

Haylett, Rebekah; Grant, Jonathan; Williams, Mark A.; Gustafson, Owen

doi:10.1080/09638288.2024.2310186

Cited by 2 publications

(2 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, many prior studies have focused on the potential benefit of early mobility for patients in the intensive care unit (ICU). 1-3,5,6,11,12 While admission level of care was not specifically collected in our patient population, post-ED disposition status was. In our study, nearly half of all patients were admitted to the floor and only about 20% went to an ICU (the other 30% left the emergency department for the operating room or other procedural area).…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have shown that early mobility is associated with a host of improved outcomes: decreased hospital length of stay, decreased ICU length of stay, and improved short-and long-term functional outcomes, as well as increased likelihood of discharge to home. [1][2][3][4] In addition, patientreported outcomes, including less pain, swelling, and stiffness, are similarly improved with early mobility. 2,4 Just as these factors are improved with early mobility, longer periods of immobility are associated with worse outcomes.…”

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

Time to Mobility Is Associated With Pulmonary Complications in Patients With Spine Fractures

Jackson,

Thomas,

Joyner

et al. 2024

The American Surgeon™

View full text Add to dashboard Cite

Introduction Treatment of spine fractures may require periods of prolonged immobilization which prevents effective pulmonary toileting. We hypothesized that patients with longer time to mobilization, as measured by time to first physical therapy (PT) session, would have higher pulmonary complications. Methods We performed a retrospective review of all trauma patients with cervical and thoracolumbar spinal fractures admitted to a level 1 trauma center over a 12-month period. Demographic data collection included age, gender, BMI, pulmonary comorbidities, concomitant rib fractures, admission GCS, Injury Severity Score (ISS), GCS at 24 h, treatment with cervical or thoracolumbar immobilization, and time to first PT evaluation. The primary outcome was the presence of any one of the following complications: unplanned intubation, pneumonia, or mortality at 30 days. Multivariable logistic regression analysis was used to assess significant predictors of pulmonary complication. Results In total, 491 patients were identified. In terms of overall pulmonary complications, 10% developed pneumonia, 13% had unplanned intubation, and 6% died within 30 days. In total, 19% developed one or more complication. Overall, 25% of patients were seen by PT <48 h, 33% between 48 and 96 h, 19% at 96 h to 1 week, and 7% > 1 week. Multivariable logistic regression analysis showed that time to PT session (OR 1.010, 95% CI 1.005-1.016) and ISS (OR 1.063, 95% CI 1.026-1.102) were independently associated with pulmonary complication. Conclusion Time to mobility is independently associated with pulmonary complications in patients with spine fractures.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Time to Mobility Is Associated With Pulmonary Complications in Patients With Spine Fractures

Jackson,

Thomas,

Joyner

et al. 2024

The American Surgeon™

View full text Add to dashboard Cite

show abstract

Rehabilitation and Social Determinants of Health in Critical Illness Recovery Literature: A Systematic Review

Fresenko,

Rutherfurd,

Robinson

et al. 2024

Critical Care Explorations

View full text Add to dashboard Cite

OBJECTIVES: Patients who survive critical illness navigate arduous and disparate recovery pathways that include referrals and participation in community-based rehabilitation services. Examining rehabilitation pathways during recovery is crucial to understanding the relationship on patient-centered outcomes. Furthermore, an understanding of social determinants of health (SDOH) in relation to outcomes and rehabilitation use will help ensure equitable access for future care. Therefore, there is a need to define and understand patient care pathways, specifically rehabilitation after discharge, through a SDOH lens after surviving a critical illness to improve long-term outcomes. DATA SOURCES: MEDLINE, PubMed, Web of Science Core Collection (Clarivate), the CINAHL, and the Physiotherapy Evidence Database. STUDY SELECTION AND DATA EXTRACTION: A systematic review of the literature was completed examining literature from inception to March 2024. Articles were included if post-hospital rehabilitation utilization was reported in adult patients who survived critical illness. Discharge disposition was examined as a proxy for rehabilitation pathways. Patients were grouped by patient diagnosis for grouped analysis and reporting of data. Two independent researchers reviewed manuscripts for inclusion and data were extracted by one reviewer using Covidence. Both reviewers used the Newcastle-Ottawa Scale to assess risk of bias. DATA SYNTHESIS: Of 72 articles included, only four articles reported detailed rehabilitation utilization. The majority of the studies included were cohort studies (91.7%) with most articles using a retrospective design (56.9%). The most common patient population was acute respiratory diagnoses (51.4%). Most patients were discharged directly home from the hospital (75.4%). Race/ethnicity was the most frequently reported SDOH (43.1%) followed by insurance status (13.9%) and education (13.9%). CONCLUSIONS: The small number of articles describing rehabilitative utilization allows for limited understanding of rehabilitation pathways following critical illness. The reporting of detailed rehabilitation utilization and SDOH are limited in the literature but may play a vital role in the recovery and outcomes of survivors of critical illness.

show abstract

Does the level of mobility on ICU discharge impact post-ICU outcomes? A retrospective analysis

Cited by 2 publications

References 44 publications

Time to Mobility Is Associated With Pulmonary Complications in Patients With Spine Fractures

Time to Mobility Is Associated With Pulmonary Complications in Patients With Spine Fractures

Rehabilitation and Social Determinants of Health in Critical Illness Recovery Literature: A Systematic Review

Contact Info

Product

Resources

About