Mobilisation practices during the SARS-CoV-2 pandemic: A retrospective analysis (MobiCOVID)

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Clara M Schellenberg - , Charité – Universitätsmedizin Berlin (Author)
  • Maximilian Lindholz - , Charité – Universitätsmedizin Berlin (Author)
  • Julius J Grunow - , Charité – Universitätsmedizin Berlin (Author)
  • Sebastian Boie - , Leipzig University (Author)
  • Annika Bald - , Charité – Universitätsmedizin Berlin (Author)
  • Linus O Warner - , Charité – Universitätsmedizin Berlin (Author)
  • Bernhard Ulm - , Ulm University Medical Center (Author)
  • Annette Milnik - , University of Basel (Author)
  • Daniel Zickler - , Charité – Universitätsmedizin Berlin (Author)
  • Stefan Angermair - , Charité – Universitätsmedizin Berlin (Author)
  • Anett Reißhauer - , Charité – Universitätsmedizin Berlin (Author)
  • Martin Witzenrath - , German Center for Lung Research (DZL) (Author)
  • Mario Menk - , Department of Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus Dresden (Author)
  • Felix Balzer - , Leipzig University (Author)
  • Thomas Ocker - , Leipzig University (Author)
  • Steffen Weber-Carstens - , Charité – Universitätsmedizin Berlin (Author)
  • Stefan J Schaller - , Technical University of Munich (Author)

Abstract

BACKGROUND: Corona Virus Disease 2019 (COVID-19) patients display risk factors for intensive care unit acquired weakness (ICUAW). The pandemic increased existing barriers to mobilisation. This study aimed to compare mobilisation practices in COVID-19 and non-COVID-19 patients.

METHODS: This retrospective cohort study was conducted at Charité-Universitätsmedizin Berlin, Germany, including adult patients admitted to one of 16 ICUs between March 2018, and November 2021. The effect of COVID-19 on mobilisation level and frequency, early mobilisation (EM) and time to active sitting position (ASP) was analysed. Subgroup analysis on COVID-19 patients and the ICU type influencing mobilisation practices was performed. Mobilisation entries were converted into the ICU mobility scale (IMS) using supervised machine learning. The groups were matched using 1:1 propensity score matching.

RESULTS: A total of 12,462 patients were included, receiving 59,415 mobilisations. After matching 611 COVID-19 and non-COVID-19 patients were analysed. They displayed no significant difference in mobilisation frequency (0.4 vs. 0.3, p = 0.7), maximum IMS (3 vs. 3; p = 0.17), EM (43.2% vs. 37.8%; p = 0.06) or time to ASP (HR 0.95; 95% CI: 0.82, 1.09; p = 0.44). Subgroup analysis showed that patients in surge ICUs, i.e., temporarily created ICUs for COVID-19 patients during the pandemic, more commonly received EM (53.9% vs. 39.8%; p = 0.03) and reached higher maximum IMS (4 vs. 3; p = 0.03) without difference in mobilisation frequency (0.5 vs. 0.3; p = 0.32) or time to ASP (HR 1.15; 95% CI: 0.85, 1.56; p = 0.36).

CONCLUSION: COVID-19 did not hinder mobilisation. Those treated in surge ICUs were more likely to receive EM and reached higher mobilisation levels.

Details

Original languageEnglish
Article number101255
JournalAnaesthesia, critical care & pain medicine
Volume42
Issue number5
Publication statusPublished - 1 Oct 2023
Peer-reviewedYes

External IDs

PubMedCentral PMC10226277
Scopus 85163420850

Keywords

Keywords

  • Adult, COVID-19, Humans, Intensive Care Units, Pandemics, Retrospective Studies, SARS-CoV-2, Supervised machine learning, Physiotherapy, Early ambulation, Intensive care unit