Association between Early Rehabilitation for Mechanically Ventilated ICU Patients and their Walking Independence: A Propensity Score-matched AnalysisAuthor: Shinichi Watanabe
Background: To examine the association between early rehabilitation for mechanically ventilated Intensive Care Unit (ICU) patients and their walking independence. Methods: Among the 1,024 consecutive patientswho had been transported to the study facility using ambulance services, newly admitted to the ICU, and treated with rehabilitation during hospitalization, 236 were included, excluding those meeting the exclusion criteria. The patients were divided into early rehabilitation and control groups to retrospectively examine the rate of walking independence, period needed to achieve such independence, and course-related factors. Results: On propensity score matching, 78 pairs were selected. Analysis using the Kaplan-Meier estimator revealed thatthe early rehabilitation group needed a markedly shorter period to achieve walking independence. As for course-related factors, there were significant differences between the groups in the periods from hospital admission to the initiation of physical therapy andmobilization, as well as the frequency of delirium. Conclusion: Early rehabilitation for mechanically ventilated ICU patients may facilitate earlier mobilization. It may alsoshorten the period they need to achieve walking independence by preventing complications, such as delirium. Abbreviations: ICU: Intensive Care Unit; ICU-AD: ICU-Acquired Delirium; APACHE II: Second version of the Acute Physiology and Chronic Health Evaluation; GCS: Glasgow Coma Scale; CCI: Charlson Comorbidity Index; BI: Barthel Index; CAM-ICU: Confusion Assessment Method for the Intensive Care Unit; ROM: Range of Motion; IRB: Institutional Review Board.