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Mobilisation practices during the SARS-CoV-2 pandemic: A retrospective analysis (MobiCOVID) - 21/09/23

Doi : 10.1016/j.accpm.2023.101255 
Clara M. Schellenberg a, Maximilian Lindholz a, Julius J. Grunow a, Sebastian Boie b, Annika Bald a, Linus O. Warner a, Bernhard Ulm c, k, Annette Milnik d, Daniel Zickler e, Stefan Angermair f, Anett Reißhauer g, Martin Witzenrath h, i, Mario Menk j, Felix Balzer b, Thomas Ocker a, b, Steffen Weber-Carstens a, Stefan J. Schaller a, c,
a Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine | CCM | CVK, Berlin, Germany 
b Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Informatics, Berlin, Germany 
c Technical University of Munich, School of Medicine, Department of Anesthesiology and Intensive Care, Munich, Germany 
d Research Platform Molecular and Cognitive Neurosciences (MCN), Department of Biomedicine, University of Basel, Basel, Switzerland 
e Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany 
f Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CBF), Berlin, Germany 
g Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rehabilitation Medicine, Berlin, Germany 
h Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases, Pulmonary Medicine and Critical Care, Berlin, Germany 
i German Center for Lung Research (DZL), Berlin, Germany 
j Department of Anesthesiology and Intensive Care Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany 
k Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, University Hospital Ulm, Ulm, Germany 

Corresponding author at: Department of Anesthesiology and Intensive Care Medicine | CCM | CVK, Chariteplatz 1, 10117 Berlin, Germany.Department of Anesthesiology and Intensive Care Medicine | CCM | CVKChariteplatz 1Berlin10117Germany

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Abstract

Background

Corona Virus Disease 2019 (COVID-19) patients display risk factors for intensive care unit acquired weakness (ICUAW). The pandemic increased existing barriers to mobilisation. This study aimed to compare mobilisation practices in COVID-19 and non-COVID-19 patients.

Methods

This retrospective cohort study was conducted at Charité-Universitätsmedizin Berlin, Germany, including adult patients admitted to one of 16 ICUs between March 2018, and November 2021. The effect of COVID-19 on mobilisation level and frequency, early mobilisation (EM) and time to active sitting position (ASP) was analysed. Subgroup analysis on COVID-19 patients and the ICU type influencing mobilisation practices was performed. Mobilisation entries were converted into the ICU mobility scale (IMS) using supervised machine learning. The groups were matched using 1:1 propensity score matching.

Results

A total of 12,462 patients were included, receiving 59,415 mobilisations. After matching 611 COVID-19 and non-COVID-19 patients were analysed. They displayed no significant difference in mobilisation frequency (0.4 vs. 0.3, p = 0.7), maximum IMS (3 vs. 3; p = 0.17), EM (43.2% vs. 37.8%; p = 0.06) or time to ASP (HR 0.95; 95% CI: 0.82, 1.09; p = 0.44).

Subgroup analysis showed that patients in surge ICUs, i.e., temporarily created ICUs for COVID-19 patients during the pandemic, more commonly received EM (53.9% vs. 39.8%; p = 0.03) and reached higher maximum IMS (4 vs. 3; p = 0.03) without difference in mobilisation frequency (0.5 vs. 0.3; p = 0.32) or time to ASP (HR 1.15; 95% CI: 0.85, 1.56; p = 0.36).

Conclusion

COVID-19 did not hinder mobilisation. Those treated in surge ICUs were more likely to receive EM and reached higher mobilisation levels.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : COVID-19, Early ambulation, Intensive care unit, Physiotherapy, SARS-CoV-2, Supervised machine learning


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© 2023  Société française d'anesthésie et de réanimation (Sfar). Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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