Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study
Abstract Purpose Gait independence is one of the most important factors related to returning home from the hospital for patients treated in the intensive care unit (ICU), but the factors affecting gait independence have not been clarified. This study aimed to determine the factors affecting gait ind...
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doaj-7b37df86cd90491d88d62b8c2f9cdfe52020-11-24T21:55:21ZengBMCJournal of Intensive Care2052-04922019-11-01711910.1186/s40560-019-0404-2Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort studyShinichi Watanabe0Toru Kotani1Shunsuke Taito2Kohei Ota3Kenzo Ishii4Mika Ono5Hajime Katsukawa6Ryo Kozu7Yasunari Morita8Ritsuro Arakawa9Shuichi Suzuki10Department of Rehabilitation Medicine, National Hospital Organization, Nagoya Medical CenterDepartment of Intensive Care Medicine, School of Medicine, Showa UniversityDivision of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University HospitalDepartment of Emergency and Critical Care Medicine, Hiroshima UniversityDepartment of Anesthesia, Fukuyama City HospitalDepartment of Nursing, Nagoya University of Arts and SciencesJapanese Society for Early MobilizationDepartment of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical SciencesDepartment of Critical Care Medicine, National Hospital Organization, Nagoya Medical CenterDepartment of Critical Care Medicine, National Hospital Organization, Nagoya Medical CenterDepartment of Critical Care Medicine, National Hospital Organization, Nagoya Medical CenterAbstract Purpose Gait independence is one of the most important factors related to returning home from the hospital for patients treated in the intensive care unit (ICU), but the factors affecting gait independence have not been clarified. This study aimed to determine the factors affecting gait independence at hospital discharge using a standardized early mobilization protocol that was shared by participating hospitals. Materials and methods Patients who entered the ICU from January 2017 to March 2018 were screened. The exclusion criteria were mechanical ventilation < 48 hours, age < 18, loss of gait independence before hospitalization, being treated for neurological issues, unrecoverable disease, unavailability of continuous data, and death during ICU stay. Basic attributes, such as age, ICU length of stay, information on early mobilization while in the ICU, Medical Research Council (MRC) sum-score at ICU discharge, incidence of ICU-acquired weakness (ICU-AW) and delirium, and the degree of gait independence at hospital discharge, were collected. Gait independence was determined using a mobility scale of the Barthel Index, and the factors that impaired gait independence at hospital discharge were investigated using a Cox proportional hazard regression analysis. Results One hundred thirty-two patients were analyzed. In the univariate analysis, age, APACHE II score, duration of mechanical ventilation, ICU length of stay, incidence of delirium, and MRC sum-score at ICU discharge were extracted as significant. In the multivariate analysis, age (p = 0.014), MRC sum-score < 48 (p = 0.021), and delirium at discharge from ICU (p < 0.0001) were extracted as significant variables. Conclusions We found that age and incidence of ICU-AW and delirium were significantly related to impaired gait independence at hospital discharge.http://link.springer.com/article/10.1186/s40560-019-0404-2Gait independenceMechanical ventilationIntensive care unit-acquired weaknessEarly mobilization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shinichi Watanabe Toru Kotani Shunsuke Taito Kohei Ota Kenzo Ishii Mika Ono Hajime Katsukawa Ryo Kozu Yasunari Morita Ritsuro Arakawa Shuichi Suzuki |
spellingShingle |
Shinichi Watanabe Toru Kotani Shunsuke Taito Kohei Ota Kenzo Ishii Mika Ono Hajime Katsukawa Ryo Kozu Yasunari Morita Ritsuro Arakawa Shuichi Suzuki Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study Journal of Intensive Care Gait independence Mechanical ventilation Intensive care unit-acquired weakness Early mobilization |
author_facet |
Shinichi Watanabe Toru Kotani Shunsuke Taito Kohei Ota Kenzo Ishii Mika Ono Hajime Katsukawa Ryo Kozu Yasunari Morita Ritsuro Arakawa Shuichi Suzuki |
author_sort |
Shinichi Watanabe |
title |
Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study |
title_short |
Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study |
title_full |
Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study |
title_fullStr |
Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study |
title_full_unstemmed |
Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study |
title_sort |
determinants of gait independence after mechanical ventilation in the intensive care unit: a japanese multicenter retrospective exploratory cohort study |
publisher |
BMC |
series |
Journal of Intensive Care |
issn |
2052-0492 |
publishDate |
2019-11-01 |
description |
Abstract Purpose Gait independence is one of the most important factors related to returning home from the hospital for patients treated in the intensive care unit (ICU), but the factors affecting gait independence have not been clarified. This study aimed to determine the factors affecting gait independence at hospital discharge using a standardized early mobilization protocol that was shared by participating hospitals. Materials and methods Patients who entered the ICU from January 2017 to March 2018 were screened. The exclusion criteria were mechanical ventilation < 48 hours, age < 18, loss of gait independence before hospitalization, being treated for neurological issues, unrecoverable disease, unavailability of continuous data, and death during ICU stay. Basic attributes, such as age, ICU length of stay, information on early mobilization while in the ICU, Medical Research Council (MRC) sum-score at ICU discharge, incidence of ICU-acquired weakness (ICU-AW) and delirium, and the degree of gait independence at hospital discharge, were collected. Gait independence was determined using a mobility scale of the Barthel Index, and the factors that impaired gait independence at hospital discharge were investigated using a Cox proportional hazard regression analysis. Results One hundred thirty-two patients were analyzed. In the univariate analysis, age, APACHE II score, duration of mechanical ventilation, ICU length of stay, incidence of delirium, and MRC sum-score at ICU discharge were extracted as significant. In the multivariate analysis, age (p = 0.014), MRC sum-score < 48 (p = 0.021), and delirium at discharge from ICU (p < 0.0001) were extracted as significant variables. Conclusions We found that age and incidence of ICU-AW and delirium were significantly related to impaired gait independence at hospital discharge. |
topic |
Gait independence Mechanical ventilation Intensive care unit-acquired weakness Early mobilization |
url |
http://link.springer.com/article/10.1186/s40560-019-0404-2 |
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