Category: Geriatric Rehabilitation; Complementary Integrative Rehabilitation Medicine; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective : To investigate the rehabilitation characteristics, safety, and functional recovery in non-Western SICU patients.
Design : Retrospectively medical record reviewed study
Patients who received active rehabilitation in 2016
Setting : Hospitalized care of one teaching hospital in Korea.
Participants (or Animals, Specimens, Cadavers) : Patients in Surgical Intensive Care Unit
Interventions : Patients were required to have been treated in the SICU for at least 3 days and have received more than one active rehabilitation session from January 1 to December 31, 2016.
Prior to the daily rehabilitation session, a safety checklist was completed. Active rehabilitation treatment (activity levels of sessions are as follows, II; active range of motion (AROM)., III; Sitting, IV; Standing, V; Walking <10m, VI; Walking ≥10m) was conducted for 20–30 minutes on weekdays. We checked safety events during rehabilitation. The mobility level was evaluated weekly using the Activity Measure for Post-Acute Care (AM-PAC) score.
Main Outcome Measure(s) : Clinical characteristics, functional recovery, and safety were investigated and compared in patients aged < 65 or ≥ 65 years. Safety events were also compared between the two age groups and according to the reason for SICU admission.
Results : Data from 157 patients were included in the analysis. The number of patients who were able to stand or walk increased from 52 at the beginning of rehabilitation to 102 at the time of ICU discharge (P < 0.01). The mobility score also increased during rehabilitation (from 11.64 to 13.85, P< 0.01). Functional recovery did not differ between the two age groups. During 780 rehabilitation sessions, 23 safety events (2.95%) were noted; no significant differences were seen between the two age groups. A significant difference was noted when patients were grouped according to the reason for SICU admission (1.65% in post-operative care patients vs 4.49% in patients admitted for other reasons, P= 0.02).
Conclusions : Active rehabilitation in critically ill surgical patients is feasible and safe, and resulted in improved mobility, regardless of age. However, the reason for SICU admission should be considered.
Yu Jin Seo– Resident, Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Seoul-t'ukpyolsi
Won Kim– Assistant professor, Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Seoul-t'ukpyolsi