Receiving early mobility during an intensive care unit admission is a predictor of improved outcomes in acute respiratory failure
- PMID: 21358312
- PMCID: PMC3082620
- DOI: 10.1097/MAJ.0b013e31820ab4f6
Receiving early mobility during an intensive care unit admission is a predictor of improved outcomes in acute respiratory failure
Abstract
Introduction: Hospitals are under pressure to provide care that not only shortens hospital length of stay but also reduces subsequent hospital admissions. Hospital readmissions have received increased attention in outcome reporting. The authors identified survivors of acute respiratory failure who then required subsequent hospitalization. A cohort of acute respiratory failure survivors, who participated in an early intensive care unit (ICU) mobility program, was assessed to determine if variables from the index hospitalization predict hospital readmission or death, within 12 months of hospital discharge.
Methods: Hospital database and responses to letters mailed to 280 acute respiratory failure survivors. Univariate predictor variables shown to be associated with hospital readmission or death (P < 0.1) were included in a multiple logistic regression. A stepwise selection procedure was used to identify significant variables (P < 0.05).
Results: Of the 280 survivors, 132 (47%) had at least 1 readmission or died within the first year, 126 (45%) were not readmitted and 22 (8%) were lost to follow-up. Tracheostomy [odds ratio (OR), 4.02 (95%CI, 1.72-9.40)], female gender [OR, 1.94 (95%CI, 1.13-3.32)], a higher Charlson Comorbidity Index assessed upon index hospitalization discharge [OR, 1.15 (95%CI, 1.01-1.31)] and lack of early ICU mobility therapy [OR, 1.77 (95%CI, 1.04-3.01)] predicted readmission or death in the first year postindex hospitalization.
Conclusions: Tracheostomy, female gender, higher Charlson Comorbidity Index and lack of early ICU mobility were associated with readmissions or death during the first year. Although the mechanisms of increased hospital readmission are unclear, these findings may provide further support for early ICU mobility for patients with acute respiratory failure.
Figures
Similar articles
-
Epidemiology and Outcomes of Patients Readmitted to the Intensive Care Unit After Cardiac Intensive Care Unit Admission.Am J Cardiol. 2022 May 1;170:138-146. doi: 10.1016/j.amjcard.2022.01.038. Epub 2022 Apr 4. Am J Cardiol. 2022. PMID: 35393081
-
Intensive care unit survivors have fewer hospital readmissions and readmission days than other hospitalized patients in British Columbia.Crit Care Med. 2004 Feb;32(2):391-8. doi: 10.1097/01.CCM.0000108882.65743.91. Crit Care Med. 2004. PMID: 14758153
-
Readmission to the Intensive Care Unit: Incidence, Risk Factors, Resource Use, and Outcomes. A Retrospective Cohort Study.Ann Am Thorac Soc. 2017 Aug;14(8):1312-1319. doi: 10.1513/AnnalsATS.201611-851OC. Ann Am Thorac Soc. 2017. PMID: 28530118
-
The association of acute kidney injury in the critically ill and postdischarge outcomes: a cohort study*.Crit Care Med. 2015 Feb;43(2):354-64. doi: 10.1097/CCM.0000000000000706. Crit Care Med. 2015. PMID: 25474534
-
Who bounces back? Physiologic and other predictors of intensive care unit readmission.Crit Care Med. 2001 Mar;29(3):511-8. doi: 10.1097/00003246-200103000-00008. Crit Care Med. 2001. PMID: 11373413
Cited by
-
The way in which a physiotherapy service is structured can improve patient outcome from a surgical intensive care: a controlled clinical trial.Crit Care. 2012 Dec 11;16(6):R230. doi: 10.1186/cc11894. Crit Care. 2012. PMID: 23232109 Free PMC article. Clinical Trial.
-
Early exercise rehabilitation of muscle weakness in acute respiratory failure patients.Exerc Sport Sci Rev. 2013 Oct;41(4):208-15. doi: 10.1097/JES.0b013e3182a4e67c. Exerc Sport Sci Rev. 2013. PMID: 23873130 Free PMC article. Review.
-
Physical therapy management of a patient on portable extracorporeal membrane oxygenation as a bridge to lung transplantation: a case report.Cardiopulm Phys Ther J. 2012 Mar;23(1):30-5. Cardiopulm Phys Ther J. 2012. PMID: 22807653 Free PMC article.
-
Factors associated with receipt of physical therapy consultation in patients requiring prolonged mechanical ventilation.Dimens Crit Care Nurs. 2014 May-Jun;33(3):160-7. doi: 10.1097/DCC.0000000000000040. Dimens Crit Care Nurs. 2014. PMID: 24704742 Free PMC article.
-
Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers.Intensive Care Med. 2016 May;42(5):725-738. doi: 10.1007/s00134-016-4321-8. Epub 2016 Mar 30. Intensive Care Med. 2016. PMID: 27025938 Review.
References
-
- Gonseth J, Guallar-Castillon P, Banegas JR, et al. The effectiveness of disease management programmes in reducing hospital re-admission in older patients with heart failure: a systematic review and meta-analysis of published reports. Eur Heart J. 2004;25(18):1570–1595. - PubMed
-
- Hauptman PJ, Rich MW, Heidenreich PA, et al. The heart failure clinic: a consensus statement of the Heart Failure Society of America. J Card Fail. 2008;14(10):801–815. - PubMed
-
- Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360(14):1418–1428. - PubMed
-
- Hernandez C, Jansa M, Vidal M, et al. The burden of chronic disorders on hospital admissions prompts the need for new modalities of care: A cross-sectional analysis in a tertiary hospital. QJM. 2009;102(3):193–202. - PubMed
-
- Morris PE, Goad A, Thompson C, et al. Early ICU Mobility Therapy in the Treatment of Acute Respiratory Failure. Crit Care Med. 2008;36:2238–2243. - PubMed
