Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
- Department of Dermatology, Allergy and Venereology
- University Hospital Basel
- Humanitas University
- University of Milan - Bicocca
- Ghent University Hospital
- Charles Sturt University
- Hospital General de Castellon
- Amsterdam University Medical Centers (UMC)
- Utrecht University of Applied Sciences
- University of Brighton
- King's College Hospital NHS Foundation Trust
- Uppsala University Hospital
- Service de Médecine Intensive-Réanimation
- Hôpital Saint-Louis
Abstract
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).
Details
Original language | English |
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Pages (from-to) | 1-12 |
Number of pages | 12 |
Journal | Annals of intensive care |
Volume | 13 |
Issue number | 112 |
Publication status | E-pub ahead of print - 14 Nov 2023 |
Peer-reviewed | Yes |
External IDs
PubMedCentral | PMC10645963 |
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Scopus | 85176341574 |
ORCID | /0000-0003-3953-3253/work/151982817 |