Authors (including presenting author) :
Lo PY(1), Tao PW(1), Tang LM(1), Tsui YC(1) and Siu HK(1)
Affiliation :
(1) Physiotherapy Department, Prince of Wales Hospital
Introduction :
ICU-acquired weakness (ICUAW) is associated with poor functional recovery, increased hospital length of stay (Wang et al., 2022) and increased mortality (Zhang et al., 2019). In this context, early mobilisation (EM) has been proposed as a promising intervention to counteract ICUAW as it can improve short-term outcomes such as discharge rate, duration of mechanical ventilation (Wang et al., 2022) and muscle strength (Tipping et al., 2017). However, limited evidence has been found regarding the long-term effect of early mobilization.
Objectives :
To review the effect of the Prince of Wales Hospital (PWH) structured ICU early physiotherapy mobilisation program on the discharged-to-home rate, short-term and long-term mortality rate.
Methodology :
The hospitalisation data of 116 patients in the control group and 1456 patients recruited in the EM program implemented from October 2022 to September 2024 were retrospectively reviewed through the Clinical Management System (CMS). The control group received conventional rehabilitation. Meanwhile, the EM group received structured physiotherapy mobilisation as early as possible once with adequate cardiac and respiratory reserve, stabilised active critical illness and medical condition. The early physiotherapy mobilisation rehabilitation was classified as passive, active-assisted, active and ambulatory. Patients with unstable vital signs, grave prognosis, unstable fracture, severe burns and limb paralysis were excluded. The outcome measures included: discharged-to-home rate, short-term mortality (30, 60, and 90 days after ICU discharge) and long-term mortality (180 days after ICU discharge).
Result & Outcome :
Compared with patients in the control group, the discharged-to-home rate of the EM program group was higher by 3.15%. The short-term mortality rate was lower by 2.94%, 6.16% and 4.10% for 30, 60 and 90 days after ICU discharge respectively. The long-term mortality rate was lower by 5.68% for 180 days after ICU discharge. Conclusion The structured ICU early physiotherapy mobilisation program has improved the discharged-to-home rate. Besides, it has reduced short-term and long-term mortality rate.
