Early mobilisation in critically ill COVID-19 patients : a subanalysis of the ESICM-initiated UNITE-COVID observational study
© 2023. The Author(s)..
BACKGROUND: Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave.
METHODS: This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs.
RESULTS: Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI - 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI - 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates.
CONCLUSIONS: Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Annals of intensive care - 13(2023), 1 vom: 14. Nov., Seite 112 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kloss, Philipp [VerfasserIn] |
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| Links: |
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| Themen: |
Bed rest |
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| Anmerkungen: |
Date Revised 17.11.2023 published: Electronic ClinicalTrials.gov: NCT04836065 Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1186/s13613-023-01201-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364543825 |
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| 100 | 1 | |a Kloss, Philipp |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Early mobilisation in critically ill COVID-19 patients |b a subanalysis of the ESICM-initiated UNITE-COVID observational study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 17.11.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT04836065 | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave | ||
| 520 | |a METHODS: This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs | ||
| 520 | |a RESULTS: Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI - 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI - 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates | ||
| 520 | |a CONCLUSIONS: Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bed rest | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Critical care | |
| 650 | 4 | |a Early ambulation | |
| 650 | 4 | |a Intensive care units | |
| 650 | 4 | |a Mobilisation | |
| 650 | 4 | |a Physical therapy specialty | |
| 650 | 4 | |a SARS-CoV-2 | |
| 700 | 1 | |a Lindholz, Maximilian |e verfasserin |4 aut | |
| 700 | 1 | |a Milnik, Annette |e verfasserin |4 aut | |
| 700 | 1 | |a Azoulay, Elie |e verfasserin |4 aut | |
| 700 | 1 | |a Cecconi, Maurizio |e verfasserin |4 aut | |
| 700 | 1 | |a Citerio, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a De Corte, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Duska, Frantisek |e verfasserin |4 aut | |
| 700 | 1 | |a Galarza, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Greco, Massimiliano |e verfasserin |4 aut | |
| 700 | 1 | |a Girbes, Armand R J |e verfasserin |4 aut | |
| 700 | 1 | |a Kesecioglu, Jozef |e verfasserin |4 aut | |
| 700 | 1 | |a Mellinghoff, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Ostermann, Marlies |e verfasserin |4 aut | |
| 700 | 1 | |a Pellegrini, Mariangela |e verfasserin |4 aut | |
| 700 | 1 | |a Teboul, Jean-Louis |e verfasserin |4 aut | |
| 700 | 1 | |a De Waele, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Adrian |e verfasserin |4 aut | |
| 700 | 1 | |a Schaller, Stefan J |e verfasserin |4 aut | |
| 700 | 0 | |a ESICM UNITE COVID Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Aires, Buenos |e investigator |4 oth | |
| 700 | 1 | |a Gira, Alicia |e investigator |4 oth | |
| 700 | 1 | |a Eller, Philipp |e investigator |4 oth | |
| 700 | 1 | |a Hamid, Tarikul |e investigator |4 oth | |
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| 700 | 1 | |a Labarca, Eduardo |e investigator |4 oth | |
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| 700 | 1 | |a Parra-Tanoux, Daniela |e investigator |4 oth | |
| 700 | 1 | |a Yepes, David |e investigator |4 oth | |
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| 700 | 1 | |a Hussein, Aliae Mohamed |e investigator |4 oth | |
| 700 | 1 | |a Galal, Islam |e investigator |4 oth | |
| 700 | 1 | |a Awad, Ahmed K |e investigator |4 oth | |
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