Begazo Flores P, Supervía M, Gimeno González M, Morata Crespo A B
Servicio de Medicina Física y Rehabilitación, Hospital Universitario Miguel Servet, Zaragoza, España.
Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España; Mayo Clinic, Rochester, Minnesota, EE. UU.
Rehabilitacion (Madr). 2023 Apr-Jun;57(2):100736. doi: 10.1016/j.rh.2022.02.009. Epub 2022 Mar 7.
The COVID-19 pandemic situation has brought a considerable growth on the amount of patients requiring ICU admissions and long-term hospitalization. The present study is aimed at determining whether Rehabilitation Services has been able to reach a sufficient adaptation level, regarding the exponential increase on the demand of Rehab-related services from intensive care patients and inpatients.
Through this cross-sectional research, an online survey was implemented in various Rehabilitation Departments across Spain from December the 22, 2020 to February the 12, 2021. SORECAR (The Spanish Cardiopulmonary Rehabilitation Society) was the responsible entity for the design of the survey (ICU Rehabilitation Services Identification). Descriptive statistical analysis was conducted using SPSS.
To address the specific needs and changes arising from the new COVID-19 pandemic situation within Spanish Rehabilitation Departments.
38 hospitals from 18 cities (From a total of 49) participated in the study. The ICUs weekly demand scored 7.84 ± 6,8 Medical Consultation (MC) on average (range: 2-45). The hospitalization average was displayed as 9, 63 ± 6,2 MC/week (range: 2-55). The total worktime dedicated by physicians was 10.38 h/week, from which physiotherapists stood with 25.95 h/week. Only 7 hospitals (16.7%) counted with occupational therapists (OT) (average dedication of 5 h/week). Each Rehab-session lasted 30 min on average. 59.1% (n = 23) of the included hospitals had already implemented a specific post-covid follow-up rehab-consultation, whereas 9.1% (n = 4) of them were planning on implementing it. 64.3% (n = 24) of the surveyed centers implemented specific protocols for COVID-19 patients, while another 7.1% (n = 3) were in development progress. 48.5% (n = 18) of the surveyed centers did not owe its own specific training program within its ICUs and respiratory rehab-areas for the internal medical residents.
The pandemic situation has resulted in a substantial increase on the workload in the Spanish Rehabilitation Services. Most of the hospitals included in the present study had already implemented outpatient follow-up consultations. Rehabilitation in critical patients is an exponentially recurrent topic for this medical specialty that needs to be furtherly addressed in the nearby future.
新冠疫情形势导致需要重症监护病房（ICU）收治和长期住院的患者数量大幅增加。本研究旨在确定康复服务是否能够达到足够的适应水平，以应对重症监护患者和住院患者对康复相关服务需求的指数级增长。
通过这项横断面研究，于2020年12月22日至2021年2月12日在西班牙各地的多个康复科开展了一项在线调查。西班牙心肺康复协会（SORECAR）是该调查（ICU康复服务识别）设计的负责机构。使用SPSS进行描述性统计分析。
解决西班牙康复科因新冠疫情新形势而产生的特定需求和变化。
来自18个城市（共49个城市）的38家医院参与了该研究。ICU的每周需求量平均为7.84±6.8次医疗会诊（MC）（范围：2 - 45）。住院患者的平均需求量为9.63±6.2次MC/周（范围：2 - 55）。医生投入的总工作时间为10.38小时/周，其中物理治疗师为25.95小时/周。只有7家医院（16.7%）配备了职业治疗师（OT）（平均投入时间为5小时/周）。每次康复治疗平均持续30分钟。纳入研究的医院中有59.1%（n = 23）已经实施了特定的新冠后随访康复会诊，而其中9.1%（n = 4）计划实施。64.3%（n = 24）的被调查中心为新冠患者实施了特定方案，另有7.1%（n = 3）正在制定中。48.5%（n = 18）的被调查中心在其ICU和呼吸康复区域没有为内科住院医师制定自己的特定培训计划。
疫情导致西班牙康复服务的工作量大幅增加。本研究纳入的大多数医院已经实施了门诊随访会诊。重症患者的康复是该医学专业中一个呈指数级反复出现的话题，在不久的将来需要进一步探讨。
