Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan.
Department of Occupational Therapy, School of Health Sciences, Shinshu University, Matsumoto, Japan.
PLoS One. 2022 Mar 31;17(3):e0266348. doi: 10.1371/journal.pone.0266348. eCollection 2022.
Early rehabilitation allows patients to better perform the activities of daily living after hospital discharge. A specialized physical therapist has been assigned as part of the early rehabilitation, but the effectiveness of the program remains unclear. We investigated how early rehabilitation provided by a specialized physical therapist affects ADL in patients with sepsis.
This was a retrospective cohort study. This study's subjects were sepsis patients who entered the advanced emergency critical care center of Shinshu University Hospital between April 2014 and March 2020. Electronic medical records were reviewed to obtain information on demographic characteristics, severity score, primary source of infection, therapeutic medication, the number of days after hospital admittance until rehabilitation begins, length of hospital stay, discharge to home, and an assessment of daily living activities for each patient. The patients were divided into two groups based on whether they were treated before or after a specialized physical therapist had been hired by the advanced emergency critical care center.
Assigning a physical therapist to a patient significantly shortened the number of days until rehabilitation began. In a multivariable model, the strongest predictors of return to independent living after hospital discharge were (1) assigning a specialized physical therapist (odds ratio = 2.40; 95% confidence interval = 1.09-5.79; P = 0.050) and (2) the number of days until rehabilitation started (odds ratio = 0.24; 95% confidence interval = 0.08-0.76; P = 0.014).
Assigning a specialized physical therapist to sepsis patients at an advanced emergency critical care center significantly shortened the number of days until a patient can begin rehabilitation after hospital admittance and improved activities of daily living after hospital discharge.
Trial registration [University Hospital Medical Information Network Clinical Trials Registry, number UMIN000040570 (2020/5/28).].
早期康复可使患者在出院后更好地进行日常生活活动。已经指定了专门的物理治疗师进行早期康复，但该计划的效果尚不清楚。我们调查了专门的物理治疗师提供的早期康复如何影响败血症患者的日常生活活动能力。
这是一项回顾性队列研究。本研究的对象是 2014 年 4 月至 2020 年 3 月期间入住信州大学医院高级急诊危重病中心的败血症患者。回顾电子病历以获取人口统计学特征、严重程度评分、主要感染源、治疗药物、从入院到开始康复的天数、住院天数、出院回家以及每位患者日常生活活动评估的信息。根据患者是否在高级急诊危重病中心聘请专门的物理治疗师之前或之后接受治疗，将患者分为两组。
为患者配备物理治疗师可显著缩短开始康复的天数。在多变量模型中，出院后恢复独立生活的最强预测因素是（1）分配专门的物理治疗师（优势比=2.40；95%置信区间=1.09-5.79；P=0.050）和（2）开始康复的天数（优势比=0.24；95%置信区间=0.08-0.76；P=0.014）。
在高级急诊危重病中心为败血症患者配备专门的物理治疗师可显著缩短患者入院后开始康复的天数，并改善出院后的日常生活活动能力。
试验注册[大学医院医疗信息网络临床试验注册处，编号 UMIN000040570（2020/5/28）]。
