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年龄和呼吸机使用时长与重症新型冠状病毒肺炎患者出院时的步行独立性相关:一项单中心回顾性观察研究。

Age and period of ventilator use are related to walking independence at the time of discharge in patients with severe COVID-19 pneumonia: a single-center retrospective observational study.

作者信息

Kaneko Kento, Ishizaka Masahiro, Chiba Kouhei, Yamashita Tomoyuki, Nomi Akira, Kubo Akira, Takahashi Hitomi

机构信息

Department of Rehabilitation Medicine, Japanese Red Cross Medical Center: 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.

Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan.

出版信息

J Phys Ther Sci. 2024 Mar;36(3):142-150. doi: 10.1589/jpts.36.142. Epub 2024 Mar 1.

DOI:10.1589/jpts.36.142
PMID:38434997
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10904214/
Abstract

[Purpose] This study aimed to identify the factors and cutoffs associated with walking independence in patients with severe COVID-19 pneumonia. [Participants and Methods] In total, 112 patients with COVID-19 pneumonia (98 males and 14 females) who were hospitalized between March 2020 and August 2021 and underwent physiotherapy during mechanical ventilation were included in the study. Attributes, respiratory function, physical function, and bed-withdrawal status were compared between two groups of patients, who were classified according to their ability to walk independently at discharge. The independent variables were reduced to four components by principal component analysis. Logistic regression analysis was performed with walking independence at discharge as the dependent variable. Receiver operating characteristic curves for the extracted factors were drawn, and cutoff values were calculated. [Results] At discharge, 76 patients were able to walk independently, while 36 were not. The logistic regression analysis was adjusted according to age and mechanical ventilation time. Cutoffs were an age of 56 years and a ventilation period of 7.5 days. [Conclusion] In cases of patients with severe COVID-19 pneumonia who required ventilators, age and mechanical ventilation time were associated with ambulatory independence at discharge, indicating the importance of reducing the ventilation period by providing respiratory physiotherapy, including expectoration, positioning, and weaning.

摘要

[目的] 本研究旨在确定与重症新型冠状病毒肺炎患者步行独立性相关的因素及临界值。[参与者与方法] 本研究纳入了2020年3月至2021年8月期间住院并在机械通气期间接受物理治疗的112例新型冠状病毒肺炎患者(98例男性和14例女性)。根据出院时独立行走能力对患者进行分组,比较两组患者的属性、呼吸功能、身体功能和离床状态。通过主成分分析将自变量简化为四个成分。以出院时的步行独立性为因变量进行逻辑回归分析。绘制提取因素的受试者工作特征曲线,并计算临界值。[结果] 出院时,76例患者能够独立行走,36例不能。逻辑回归分析根据年龄和机械通气时间进行了调整。临界值为年龄56岁和通气时间7.5天。[结论] 在需要呼吸机的重症新型冠状病毒肺炎患者中,年龄和机械通气时间与出院时的步行独立性相关,这表明通过提供包括咳痰、体位摆放和撤机在内的呼吸物理治疗来缩短通气时间具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26dd/10904214/27d4c71765c1/jpts-36-142-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26dd/10904214/8095e8f8e823/jpts-36-142-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26dd/10904214/98660a951c0c/jpts-36-142-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26dd/10904214/27d4c71765c1/jpts-36-142-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26dd/10904214/8095e8f8e823/jpts-36-142-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26dd/10904214/98660a951c0c/jpts-36-142-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26dd/10904214/27d4c71765c1/jpts-36-142-g003.jpg

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