| アブストラクト | OBJECTIVE: To examine the effects of intensive rehabilitation on mortality and liberation from mechanical ventilation among patients with mechanical ventilation in intensive care units. DESIGN: Retrospective cohort study using the Diagnosis Procedure Combination inpatient database. SETTING: Patients discharged from acute care hospitals from April 2010 to March 2016. PARTICIPANTS: Patients (N=46,438) aged 20 years and older who were admitted to intensive care units and who started rehabilitation within 3 days of starting mechanical ventilation. INTERVENTION: Intensive rehabilitation in intensive care unit in the first 5 days after admission. Amount of rehabilitation was defined as the average number of units per day in the first 5 days after admission and was dichotomized as intensive (>/=1.0 unit/d) or nonintensive (<1.0 unit/d) rehabilitation. MAIN OUTCOME MEASURES: The primary outcome was in-hospital mortality. The secondary outcome was liberation from mechanical ventilation. RESULTS: We identified 29,982 eligible patients, including intensive (n=7745) and nonintensive (n=22,237) rehabilitation groups. In the propensity score-matched analysis, the intensive rehabilitation group had significantly lower in-hospital mortality (risk difference: -3.4%; 95% CI, -4.9% to -1.9%) and a higher proportion of liberation from mechanical ventilation (subdistribution hazard ratio, 1.08; 95% CI, 1.03-1.13) compared with the nonintensive rehabilitation group. CONCLUSIONS: Patients receiving a higher amount of rehabilitation in intensive care units were less likely to die and more likely to be liberated from mechanical ventilation. |
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| ジャーナル名 | Archives of physical medicine and rehabilitation |
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| 投稿日 | 2020/11/21 |
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| 投稿者 | Yagi, Maiko; Morita, Kojiro; Matsui, Hiroki; Michihata, Nobuaki; Fushimi, Kiyohide; Koyama, Teruyuki; Fujitani, Junko; Yasunaga, Hideo |
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| 組織名 | Department of Rehabilitation, St. Marianna University School of Medicine, Toyoko;Hospital, Kanagawa, Japan. Electronic address: maimaigoat@marianna-u.ac.jp.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan.;Department of Rehabilitation, Kameda Medical Center, Chiba, Japan.;Department of Rehabilitation, National Center for Global Health and Medicine,;Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33213824/ |
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