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心血管疾病住院患者 ICU 中功能特征和物理治疗与 COVID-19 死亡率的关联。

Association of Functional Characteristics and Physiotherapy with COVID-19 Mortality in Intensive Care Unit in Inpatients with Cardiovascular Diseases.

机构信息

Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro 20080-003, Brazil.

Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria.

出版信息

Medicina (Kaunas). 2022 Jun 18;58(6):823. doi: 10.3390/medicina58060823.

Abstract

Background and Objectives: To estimate the association between admission functional outcomes and exposure to physiotherapy interventions with mortality rate in intensive care unit (ICU) inpatients with cardiovascular diseases and new coronavirus disease (COVID-19). Materials and Methods: Retrospective cohort including 100 ICU inpatients (mean (standard deviation), age 75 (16) years) split into COVID-19+ or COVID-19−. The association of in-ICU death with admission functional outcomes and physiotherapy interventions was investigated using univariable and multivariable regression models. Results: In total, 42 (42%) patients tested positive for COVID-19. In-ICU mortality rate was 37%, being higher for the COVID-19+ group (odds ratio, OR (95% CI): 3.15 (1.37−7.47), p = 0.008). In-ICU death was associated with lower admission ICU Mobility Scale score (0.81 (0.71−0.91), p = 0.001). Restricted mobility (24.90 (6.77−161.94), p < 0.001) and passive kinesiotherapy (30.67 (9.49−139.52), p < 0.001) were associated with in-ICU death, whereas active kinesiotherapy (0.13 (0.05−0.32), p < 0.001), standing (0.12 (0.05−0.30), p < 0.001), or walking (0.10 (0.03−0.27), p < 0.001) were associated with in-ICU discharge. Conclusions: In-ICU mortality was higher for inpatients with cardiovascular diseases who had COVID-19+, were exposed to invasive mechanical ventilation, or presented with low admission mobility scores. Restricted mobility or passive kinesiotherapy were associated with in-ICU death, whereas active mobilizations (kinesiotherapy, standing, or walking) were associated with in-ICU discharge in this population.

摘要

背景与目的

评估心血管疾病和新型冠状病毒病(COVID-19)患者入住重症监护病房(ICU)时的入院功能结局与接受物理治疗干预情况与死亡率之间的关系。材料与方法:本回顾性队列研究纳入了 100 名 ICU 住院患者(平均(标准差)年龄 75(16)岁),分为 COVID-19+组或 COVID-19−组。使用单变量和多变量回归模型探讨 ICU 内死亡与入院功能结局和物理治疗干预之间的关系。结果:共有 42 名(42%)患者 COVID-19 检测呈阳性。ICU 死亡率为 37%,COVID-19+组更高(比值比,95%置信区间:3.15(1.37-7.47),p=0.008)。ICU 内死亡与入院 ICU 移动量表评分较低相关(0.81(0.71-0.91),p=0.001)。限制移动(24.90(6.77-161.94),p<0.001)和被动运动疗法(30.67(9.49-139.52),p<0.001)与 ICU 内死亡相关,而主动运动疗法(0.13(0.05-0.32),p<0.001)、站立(0.12(0.05-0.30),p<0.001)或行走(0.10(0.03-0.27),p<0.001)与 ICU 出院相关。结论:患有心血管疾病且 COVID-19 阳性、接受有创机械通气或入院时移动评分较低的患者 ICU 死亡率更高。限制移动或被动运动疗法与 ICU 内死亡相关,而该人群中主动运动疗法(运动疗法、站立或行走)与 ICU 出院相关。

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