Outcome of Early Mobilization of Critically Ill Patients: A Propensity Score Matching Trial

Abstract

Critically ill patients are frequently immobilized which exposes them to multiple hazards particularly muscle weakness. Early mobilization of those patients was proposed few years ago and may be associated with improvement of patient's outcomes, especially reduction of ICU length of stay.Aim: To report the results of a quality improvement project of early mobilization in a tertiary center ICU.Method: A full detailed protocol was developed for the intervention and applied in the ICU as of January 2017. Outcomes of enrolled patients were compared to that of un-enrolled patients. The impact of the program on ICU LOS was evaluated by propensity score matching, using un-enrolled patients as controls.Results: Propensity score matching yielded a significant impact on LOS in the form of average reduction of 8.6 days (95% CI: 3.4-13.8, p=0.001), the average ICU LOS of enrolled patients was significantly lower than that of un-enrolled (15.8±8.2 vs. 21±9, p=0.04), as well as the duration of weaning trials duration (4.1±2.6 vs. 7.6±5.2, p=0.03), there was no difference in ICU mortality (p=0.07). Conclusion:Early mobilization of critically ill patients may be associated with reduced ICU LOS and weaning trial period.

Effect of Tocilizumab on “ventilator free days” composite outcome in SARS-CoV-2 patients. A retrospective competing risk analysis

“…Matching was 1:1 nearest neighbor method with a caliber width of 0.2 without replacement. The reason we didn't follow the classical method of propensity score matching where logistic regression is performed using receiving TCZ as the dependent to identify variables to match upon (15) is that we expected a small number of patients receiving TCZ with numerous matching criteria so that if all were included in a logistic regression model would have violated the rule of thumb of 10 events / variable and that would have resulted in over fitting (16) .…”