Journal des soins intensifs et critiques Libre accès

Abstrait

Outcome of Early Mobilization of Critically Ill Patients: A Propensity Score Matching Trial

Waleed Tharwat Aletreby, Shahzad Ahmed Mumtaz, Abdulrahman Mishaal Al Harthy, Saima Akhtar Shahzad, Omar Elsayed Ramadan, Ahmed Fouad Mady, Nasir Naseem Mahmood, Basim Mohammed Huwait and Mohammed Ali Al Odat

Critically ill patients are frequently immobilized which exposes them to multiple hazards particularly muscle weakness. Early mobilization of those patients was proposed few years ago and may be associated with improvement of patient’s outcomes, especially reduction of ICU length of stay.

Aim: To report the results of a quality improvement project of early mobilization in a tertiary center ICU.

Method: A full detailed protocol was developed for the intervention and applied in the ICU as of January 2017. Outcomes of enrolled patients were compared to that of un-enrolled patients. The impact of the program on ICU LOS was evaluated by propensity score matching, using un-enrolled patients as controls.

Results: Propensity score matching yielded a significant impact on LOS in the form of average reduction of 8.6 days (95% CI: 3.4-13.8, p=0.001), the average ICU LOS of enrolled patients was significantly lower than that of un-enrolled (15.8±8.2 vs. 21±9, p=0.04), as well as the duration of weaning trials duration (4.1±2.6 vs. 7.6±5.2, p=0.03), there was no difference in ICU mortality (p=0.07).

Conclusion: Early mobilization of critically ill patients may be associated with reduced ICU LOS and weaning trial period.