Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Kloss, Philipp [verfasserIn] Lindholz, Maximilian Milnik, Annette Azoulay, Elie Cecconi, Maurizio Citerio, Giuseppe De Corte, Thomas Duska, Frantisek Galarza, Laura Greco, Massimiliano Girbes, Armand R. J. Kesecioglu, Jozef Mellinghoff, Johannes Ostermann, Marlies Pellegrini, Mariangela Teboul, Jean-Louis De Waele, Jan Wong, Adrian Schaller, Stefan J.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	COVID-19 SARS-CoV-2 Early ambulation Critical care Intensive care units Physical therapy specialty Bed rest Mobilisation

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: Annals of intensive care - Heidelberg : Springer, 2011, 13(2023), 1 vom: 14. Nov.
Übergeordnetes Werk:	volume:13 ; year:2023 ; number:1 ; day:14 ; month:11

Links:	Volltext

DOI / URN:	10.1186/s13613-023-01201-1

Katalog-ID:	SPR053742222

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520			\|a Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021).
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allfields	10.1186/s13613-023-01201-1 doi (DE-627)SPR053742222 (SPR)s13613-023-01201-1-e DE-627 ger DE-627 rakwb eng Kloss, Philipp verfasserin (orcid)0009-0006-5424-1290 aut Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Early ambulation (dpeaa)DE-He213 Critical care (dpeaa)DE-He213 Intensive care units (dpeaa)DE-He213 Physical therapy specialty (dpeaa)DE-He213 Bed rest (dpeaa)DE-He213 Mobilisation (dpeaa)DE-He213 Lindholz, Maximilian (orcid)0000-0003-3690-1161 aut Milnik, Annette (orcid)0000-0002-3933-3289 aut Azoulay, Elie (orcid)0000-0002-8162-1508 aut Cecconi, Maurizio (orcid)0000-0002-4376-6538 aut Citerio, Giuseppe (orcid)0000-0002-5374-3161 aut De Corte, Thomas (orcid)0000-0001-5011-6640 aut Duska, Frantisek (orcid)0000-0003-1559-4078 aut Galarza, Laura (orcid)0000-0002-4658-748X aut Greco, Massimiliano (orcid)0000-0003-1003-4637 aut Girbes, Armand R. J. (orcid)0000-0002-0711-0494 aut Kesecioglu, Jozef (orcid)0000-0002-3007-8445 aut Mellinghoff, Johannes (orcid)0000-0002-5455-8953 aut Ostermann, Marlies (orcid)0000-0001-9500-9080 aut Pellegrini, Mariangela (orcid)0000-0001-5668-7399 aut Teboul, Jean-Louis (orcid)0000-0002-5748-7820 aut De Waele, Jan (orcid)0000-0003-1017-9748 aut Wong, Adrian (orcid)0000-0003-4968-7328 aut Schaller, Stefan J. (orcid)0000-0002-6683-9584 aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 13(2023), 1 vom: 14. Nov. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:13 year:2023 number:1 day:14 month:11 https://dx.doi.org/10.1186/s13613-023-01201-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2023 1 14 11
spelling	10.1186/s13613-023-01201-1 doi (DE-627)SPR053742222 (SPR)s13613-023-01201-1-e DE-627 ger DE-627 rakwb eng Kloss, Philipp verfasserin (orcid)0009-0006-5424-1290 aut Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Early ambulation (dpeaa)DE-He213 Critical care (dpeaa)DE-He213 Intensive care units (dpeaa)DE-He213 Physical therapy specialty (dpeaa)DE-He213 Bed rest (dpeaa)DE-He213 Mobilisation (dpeaa)DE-He213 Lindholz, Maximilian (orcid)0000-0003-3690-1161 aut Milnik, Annette (orcid)0000-0002-3933-3289 aut Azoulay, Elie (orcid)0000-0002-8162-1508 aut Cecconi, Maurizio (orcid)0000-0002-4376-6538 aut Citerio, Giuseppe (orcid)0000-0002-5374-3161 aut De Corte, Thomas (orcid)0000-0001-5011-6640 aut Duska, Frantisek (orcid)0000-0003-1559-4078 aut Galarza, Laura (orcid)0000-0002-4658-748X aut Greco, Massimiliano (orcid)0000-0003-1003-4637 aut Girbes, Armand R. J. (orcid)0000-0002-0711-0494 aut Kesecioglu, Jozef (orcid)0000-0002-3007-8445 aut Mellinghoff, Johannes (orcid)0000-0002-5455-8953 aut Ostermann, Marlies (orcid)0000-0001-9500-9080 aut Pellegrini, Mariangela (orcid)0000-0001-5668-7399 aut Teboul, Jean-Louis (orcid)0000-0002-5748-7820 aut De Waele, Jan (orcid)0000-0003-1017-9748 aut Wong, Adrian (orcid)0000-0003-4968-7328 aut Schaller, Stefan J. (orcid)0000-0002-6683-9584 aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 13(2023), 1 vom: 14. Nov. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:13 year:2023 number:1 day:14 month:11 https://dx.doi.org/10.1186/s13613-023-01201-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2023 1 14 11
allfields_unstemmed	10.1186/s13613-023-01201-1 doi (DE-627)SPR053742222 (SPR)s13613-023-01201-1-e DE-627 ger DE-627 rakwb eng Kloss, Philipp verfasserin (orcid)0009-0006-5424-1290 aut Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Early ambulation (dpeaa)DE-He213 Critical care (dpeaa)DE-He213 Intensive care units (dpeaa)DE-He213 Physical therapy specialty (dpeaa)DE-He213 Bed rest (dpeaa)DE-He213 Mobilisation (dpeaa)DE-He213 Lindholz, Maximilian (orcid)0000-0003-3690-1161 aut Milnik, Annette (orcid)0000-0002-3933-3289 aut Azoulay, Elie (orcid)0000-0002-8162-1508 aut Cecconi, Maurizio (orcid)0000-0002-4376-6538 aut Citerio, Giuseppe (orcid)0000-0002-5374-3161 aut De Corte, Thomas (orcid)0000-0001-5011-6640 aut Duska, Frantisek (orcid)0000-0003-1559-4078 aut Galarza, Laura (orcid)0000-0002-4658-748X aut Greco, Massimiliano (orcid)0000-0003-1003-4637 aut Girbes, Armand R. J. (orcid)0000-0002-0711-0494 aut Kesecioglu, Jozef (orcid)0000-0002-3007-8445 aut Mellinghoff, Johannes (orcid)0000-0002-5455-8953 aut Ostermann, Marlies (orcid)0000-0001-9500-9080 aut Pellegrini, Mariangela (orcid)0000-0001-5668-7399 aut Teboul, Jean-Louis (orcid)0000-0002-5748-7820 aut De Waele, Jan (orcid)0000-0003-1017-9748 aut Wong, Adrian (orcid)0000-0003-4968-7328 aut Schaller, Stefan J. (orcid)0000-0002-6683-9584 aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 13(2023), 1 vom: 14. Nov. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:13 year:2023 number:1 day:14 month:11 https://dx.doi.org/10.1186/s13613-023-01201-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2023 1 14 11
allfieldsGer	10.1186/s13613-023-01201-1 doi (DE-627)SPR053742222 (SPR)s13613-023-01201-1-e DE-627 ger DE-627 rakwb eng Kloss, Philipp verfasserin (orcid)0009-0006-5424-1290 aut Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Early ambulation (dpeaa)DE-He213 Critical care (dpeaa)DE-He213 Intensive care units (dpeaa)DE-He213 Physical therapy specialty (dpeaa)DE-He213 Bed rest (dpeaa)DE-He213 Mobilisation (dpeaa)DE-He213 Lindholz, Maximilian (orcid)0000-0003-3690-1161 aut Milnik, Annette (orcid)0000-0002-3933-3289 aut Azoulay, Elie (orcid)0000-0002-8162-1508 aut Cecconi, Maurizio (orcid)0000-0002-4376-6538 aut Citerio, Giuseppe (orcid)0000-0002-5374-3161 aut De Corte, Thomas (orcid)0000-0001-5011-6640 aut Duska, Frantisek (orcid)0000-0003-1559-4078 aut Galarza, Laura (orcid)0000-0002-4658-748X aut Greco, Massimiliano (orcid)0000-0003-1003-4637 aut Girbes, Armand R. J. (orcid)0000-0002-0711-0494 aut Kesecioglu, Jozef (orcid)0000-0002-3007-8445 aut Mellinghoff, Johannes (orcid)0000-0002-5455-8953 aut Ostermann, Marlies (orcid)0000-0001-9500-9080 aut Pellegrini, Mariangela (orcid)0000-0001-5668-7399 aut Teboul, Jean-Louis (orcid)0000-0002-5748-7820 aut De Waele, Jan (orcid)0000-0003-1017-9748 aut Wong, Adrian (orcid)0000-0003-4968-7328 aut Schaller, Stefan J. (orcid)0000-0002-6683-9584 aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 13(2023), 1 vom: 14. Nov. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:13 year:2023 number:1 day:14 month:11 https://dx.doi.org/10.1186/s13613-023-01201-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2023 1 14 11
allfieldsSound	10.1186/s13613-023-01201-1 doi (DE-627)SPR053742222 (SPR)s13613-023-01201-1-e DE-627 ger DE-627 rakwb eng Kloss, Philipp verfasserin (orcid)0009-0006-5424-1290 aut Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Early ambulation (dpeaa)DE-He213 Critical care (dpeaa)DE-He213 Intensive care units (dpeaa)DE-He213 Physical therapy specialty (dpeaa)DE-He213 Bed rest (dpeaa)DE-He213 Mobilisation (dpeaa)DE-He213 Lindholz, Maximilian (orcid)0000-0003-3690-1161 aut Milnik, Annette (orcid)0000-0002-3933-3289 aut Azoulay, Elie (orcid)0000-0002-8162-1508 aut Cecconi, Maurizio (orcid)0000-0002-4376-6538 aut Citerio, Giuseppe (orcid)0000-0002-5374-3161 aut De Corte, Thomas (orcid)0000-0001-5011-6640 aut Duska, Frantisek (orcid)0000-0003-1559-4078 aut Galarza, Laura (orcid)0000-0002-4658-748X aut Greco, Massimiliano (orcid)0000-0003-1003-4637 aut Girbes, Armand R. J. (orcid)0000-0002-0711-0494 aut Kesecioglu, Jozef (orcid)0000-0002-3007-8445 aut Mellinghoff, Johannes (orcid)0000-0002-5455-8953 aut Ostermann, Marlies (orcid)0000-0001-9500-9080 aut Pellegrini, Mariangela (orcid)0000-0001-5668-7399 aut Teboul, Jean-Louis (orcid)0000-0002-5748-7820 aut De Waele, Jan (orcid)0000-0003-1017-9748 aut Wong, Adrian (orcid)0000-0003-4968-7328 aut Schaller, Stefan J. (orcid)0000-0002-6683-9584 aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 13(2023), 1 vom: 14. Nov. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:13 year:2023 number:1 day:14 month:11 https://dx.doi.org/10.1186/s13613-023-01201-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2023 1 14 11
language	English
source	Enthalten in Annals of intensive care 13(2023), 1 vom: 14. Nov. volume:13 year:2023 number:1 day:14 month:11
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authorswithroles_txt_mv	Kloss, Philipp @@aut@@ Lindholz, Maximilian @@aut@@ Milnik, Annette @@aut@@ Azoulay, Elie @@aut@@ Cecconi, Maurizio @@aut@@ Citerio, Giuseppe @@aut@@ De Corte, Thomas @@aut@@ Duska, Frantisek @@aut@@ Galarza, Laura @@aut@@ Greco, Massimiliano @@aut@@ Girbes, Armand R. J. @@aut@@ Kesecioglu, Jozef @@aut@@ Mellinghoff, Johannes @@aut@@ Ostermann, Marlies @@aut@@ Pellegrini, Mariangela @@aut@@ Teboul, Jean-Louis @@aut@@ De Waele, Jan @@aut@@ Wong, Adrian @@aut@@ Schaller, Stefan J. @@aut@@
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There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. 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author	Kloss, Philipp
spellingShingle	Kloss, Philipp misc COVID-19 misc SARS-CoV-2 misc Early ambulation misc Critical care misc Intensive care units misc Physical therapy specialty misc Bed rest misc Mobilisation Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study
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topic_title	Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Early ambulation (dpeaa)DE-He213 Critical care (dpeaa)DE-He213 Intensive care units (dpeaa)DE-He213 Physical therapy specialty (dpeaa)DE-He213 Bed rest (dpeaa)DE-He213 Mobilisation (dpeaa)DE-He213
topic	misc COVID-19 misc SARS-CoV-2 misc Early ambulation misc Critical care misc Intensive care units misc Physical therapy specialty misc Bed rest misc Mobilisation
topic_unstemmed	misc COVID-19 misc SARS-CoV-2 misc Early ambulation misc Critical care misc Intensive care units misc Physical therapy specialty misc Bed rest misc Mobilisation
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title_full	Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study
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author_browse	Kloss, Philipp Lindholz, Maximilian Milnik, Annette Azoulay, Elie Cecconi, Maurizio Citerio, Giuseppe De Corte, Thomas Duska, Frantisek Galarza, Laura Greco, Massimiliano Girbes, Armand R. J. Kesecioglu, Jozef Mellinghoff, Johannes Ostermann, Marlies Pellegrini, Mariangela Teboul, Jean-Louis De Waele, Jan Wong, Adrian Schaller, Stefan J.
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title_sort	early mobilisation in critically ill covid-19 patients: a subanalysis of the esicm-initiated unite-covid observational study
title_auth	Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study
abstract	Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). © The Author(s) 2023
abstractGer	Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). © The Author(s) 2023
abstract_unstemmed	Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021). © The Author(s) 2023
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container_issue	1
title_short	Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study
url	https://dx.doi.org/10.1186/s13613-023-01201-1
remote_bool	true
author2	Lindholz, Maximilian Milnik, Annette Azoulay, Elie Cecconi, Maurizio Citerio, Giuseppe De Corte, Thomas Duska, Frantisek Galarza, Laura Greco, Massimiliano Girbes, Armand R. J. Kesecioglu, Jozef Mellinghoff, Johannes Ostermann, Marlies Pellegrini, Mariangela Teboul, Jean-Louis De Waele, Jan Wong, Adrian Schaller, Stefan J.
author2Str	Lindholz, Maximilian Milnik, Annette Azoulay, Elie Cecconi, Maurizio Citerio, Giuseppe De Corte, Thomas Duska, Frantisek Galarza, Laura Greco, Massimiliano Girbes, Armand R. J. Kesecioglu, Jozef Mellinghoff, Johannes Ostermann, Marlies Pellegrini, Mariangela Teboul, Jean-Louis De Waele, Jan Wong, Adrian Schaller, Stefan J.
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isOA_txt	true
hochschulschrift_bool	false
doi_str	10.1186/s13613-023-01201-1
up_date	2024-07-03T21:42:19.976Z
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Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

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