Department of Rehabilitation Medicine, Pusan National University Hospital, Busan 49241, Republic of Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea.
Medicina (Kaunas). 2024 Oct 20;60(10):1719. doi: 10.3390/medicina60101719.
: In this study, we evaluated clinical factors associated with implementing a rehabilitation program for patients with COVID-19-associated acute respiratory distress syndrome (ARDS) requiring mechanical ventilation (MV) during the quarantine period. : This observational study was conducted in the National Designated Isolated ICU, a dedicated COVID-19 center with 18 beds, from 30 December 2020 to 30 May 2022. One hundred and fifty-four patients (mean age: 67.3 ± 13.4 years; male: 59.7%) were enrolled. The ICU rehabilitation program included early mobilization, chest physiotherapy, and dysphagia treatment. : Forty-five patients (29.3%) participated in the rehabilitation program. Multivariate logistic regression identified three significant factors: tracheostomy (odds ratio [OR], 2.796; 95% confidence interval [CI], 1.238-6.316; = 0.013), body mass index ≥ 25.0 kg/m (OR, 2.724; 95% CI, 1.276-5.817; = 0.010), and extracorporeal membrane oxygenation (OR, 2.931; 95% CI, 1.165-7.377; = 0.022); patients with all three factors were younger (median 44 vs. 70 years, < 0.001) and had significantly lower Acute Physiology and Chronic Health Evaluation II scores (median 12 vs. 16, = 0.002) on the MV day. One-year cumulative mortality rates for patients with 0 to 3 factors were 66.7%, 50.8%, 38.9%, and 15.4%, respectively, with a significant difference among them (log-rank, < 0.001). : Three clinical factors associated with implementing a rehabilitation program during the quarantine period for COVID-19-associated ARDS patients were identified. The program was feasible and beneficial, particularly for younger patients with lower illness severity and fewer comorbidities on the day of MV.
在这项研究中,我们评估了与在隔离期间为因 COVID-19 相关的急性呼吸窘迫综合征(ARDS)而需要机械通气(MV)的患者实施康复计划相关的临床因素。
这项观察性研究在国家指定隔离 ICU 进行,这是一个专门的 COVID-19 中心,有 18 张床位,时间为 2020 年 12 月 30 日至 2022 年 5 月 30 日。共纳入 154 名患者(平均年龄:67.3±13.4 岁;男性:59.7%)。ICU 康复计划包括早期活动、胸部物理治疗和吞咽困难治疗。
45 名患者(29.3%)参加了康复计划。多变量逻辑回归确定了三个重要因素:气管切开术(比值比[OR],2.796;95%置信区间[CI],1.238-6.316; = 0.013)、体质指数≥25.0 kg/m(OR,2.724;95% CI,1.276-5.817; = 0.010)和体外膜氧合(OR,2.931;95% CI,1.165-7.377; = 0.022);所有三个因素的患者均更年轻(中位数 44 岁 vs. 70 岁, <0.001),MV 日的急性生理学和慢性健康评估 II 评分明显更低(中位数 12 分 vs. 16 分, = 0.002)。有 0 到 3 个因素的患者 1 年累积死亡率分别为 66.7%、50.8%、38.9%和 15.4%,组间差异有统计学意义(对数秩检验, <0.001)。
确定了与 COVID-19 相关 ARDS 患者在隔离期间实施康复计划相关的三个临床因素。该计划是可行且有益的,特别是对 MV 当天病情较轻、合并症较少的年轻患者。