Effectiveness of Early Versus Delayed Physical Rehabilitation on In‐Hospital Mortality in Interstitial Pneumonia: A Retrospective Cohort Study

Abstract

Introduction Although early rehabilitation for acute inpatients is widely recommended, the effectiveness of early physical rehabilitation for interstitial pneumonia in the acute setting remains unclear. Objective To investigate the impact of early rehabilitation on mortality in patients with interstitial pneumonia in the acute setting. Design Retrospective cohort study used a hospital‐based database created by the Japan Medical Data Center. Setting Over 100 acute‐care hospitals across Japan. Participants Inpatients hospitalized due to interstitial pneumonia from 2014 to 2018. Interventions Early rehabilitation provided by physical therapists and/or occupational therapists within 2 day of admission. Main Outcome Measures Thirty‐ and 90‐day in‐hospital mortality. Results Among the included inpatients, 847 (50%) underwent early rehabilitation. Mortality was significantly lower in the early rehabilitation group compared with the delayed rehabilitation group (30‐day mortality: 6.8% vs 12.1%, 90‐day mortality: 13.0% vs 19.8%). The differences were significant after propensity score adjustment using inverse probability weighting (30‐day mortality: 7.6% vs 11.0%, 90‐day mortality: 14.3% vs 18.0%). Conclusion Early rehabilitation was associated with decreased mortality in hospitalized patients with interstitial pneumonia.

Rehabilitation programs for patients with COronaVIrus Disease 2019: consensus statements of Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation

“… 2 Studies have shown that early rehabilitation interventions for community-acquired pneumonia and interstitial pneumonia within 2 days of admission reduced in-hospital mortality. 26 , 27 The two primary objectives of rehabilitation in this stage are promoting airway clearance and preventing complications of acute illness-related immobilization.…”

Data resource profile: JMDC claims databases sourced from Medical Institutions

“…Data are currently still being added to the database. 4. In order to protect personal information, data from medical institutions are collected as information that has been anonymized in accordance with Clause 2:9 of the Law for the Protection of Personal Information, on the basis of a personal ID for each medical institution with which individuals cannot be identified.…”

“…Research carried out using this database includes the following: Factor analysis of outcome 3‐4 Patient characteristics 5‐6 Validations of indices 7 …”