To examine the relationship between physical rehabilitation parameters including an approach to quantifying dosage with hospital outcomes for patients with critical COVID-19. Retrospective practice analysis from March 5, 2020, to April 15, 2021. Intensive care units (ICU) at four medical institutions. n = 3780 adults with ICU admission and diagnosis of COVID-19. We measured the physical rehabilitation treatment delivered in ICU and patient outcomes: (1) mortality; (2) discharge disposition; and (3) physical function at hospital discharge measured by the Activity Measure-Post Acute Care (AM-PAC) “6-Clicks” (6–24, 24 = greater functional independence). Physical rehabilitation dosage was defined as the average mobility level scores in the first three sessions (a surrogate measure of intensity) multiplied by the rehabilitation frequency (PT + OT frequency in hospital). The cohort was a mean 64 ± 16 years old, 41% female, mean BMI of 32 ± 9 kg/m2 and 46% (n = 1739) required mechanical ventilation. For 2191 patients who received rehabilitation, the dosage and AM-PAC at discharge were moderately, positively associated (Spearman’s rho [r] = 0.484, p < 0.001). Multivariate linear regression (model adjusted R2 = 0.68, p < 0.001) demonstrates mechanical ventilation (β = − 0.86, p = 0.001), average mobility score in first three sessions (β = 2.6, p < 0.001) and physical rehabilitation dosage (β = 0.22, p = 0.001) were predictive of AM-PAC scores at discharge when controlling for age, sex, BMI, and ICU LOS. Greater physical rehabilitation exposure early in the ICU is associated with better physical function at hospital discharge.

中文翻译：

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重症监护病房的早期物理康复剂量与危重 COVID-19 后的医院结果相关


检查物理康复参数之间的关系，包括一种量化重症 COVID-19 患者剂量与医院结果的方法。2020 年 3 月 5 日至 2021 年 4 月 15 日的回顾性实践分析。四家医疗机构的重症监护病房 （ICU）。n = 3780 名入住 ICU 并诊断为 COVID-19 的成年人。我们测量了 ICU 提供的物理康复治疗和患者结局：（1） 死亡率;（2） 出院处置;（3） 通过活动测量-急性护理后 （AM-PAC） “6-Clicks” 测量出院时的身体功能（6-24,24 = 更大的功能独立性）。物理康复剂量定义为前三个疗程的平均活动水平评分（强度的替代测量）乘以康复频率（医院的 PT + OT 频率）。该队列平均 64 ± 16 岁，41% 为女性，平均 BMI 为 32 ± 9 kg/m2,46% （n = 1739） 需要机械通气。对于 2191 名接受康复治疗的患者，出院时的剂量和 AM-PAC 呈中度正相关 （Spearman rho [r] = 0.484，p < 0.001）。多变量线性回归 （模型调整 R2 = 0.68，p < 0.001） 显示机械通气 （β = − 0.86，p = 0.001）、前三个会话的平均活动评分 （β = 2.6，p < 0.001） 和物理康复剂量 （β = 0.22，p = 0.001） 在控制年龄、性别、BMI 和 ICU LOS 时预测出院时的 AM-PAC 评分。ICU 早期更多的身体康复暴露与出院时更好的身体功能相关。