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Relationship between Use of Rehabilitation Resources and ICU Readmission and ER Visits in ICU Survivors: the Korean ICU National Data Study 2008-2015

Journal of Korean Medical Science 2020년 35권 15호 p.101 ~ 101
박연희 ( Park Yun-Hee ) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Physical Medicine and Rehabilitation

 ( Ko Ryoung-Eun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Critical Care Medicine
강단비 ( Kang Dan-Bee ) - Sungkyunkwan University SAIHST Department of Clinical Research Design and Evaluation
박진경 ( Park Jin-Kyeong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Critical Care Medicine
전경만 ( Jeon Kyeong-Man ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Critical Care Medicine
양정훈 ( Yang Jeong-Hoon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Critical Care Medicine
박치민 ( Park Chi-Min ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Critical Care Medicine
조중범 ( Cho Joong-Bum ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Critical Care Medicine
박영숙 ( Park Young-Sook ) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Physical Medicine and Rehabilitation
박혜정 ( Park Hye-Jung ) - Sungkyunkwan University SAIHST Department of Clinical Research Design and Evaluation
조주희 ( Cho Ju-Hee ) - Sungkyunkwan University SAIHST Department of Clinical Research Design and Evaluation
 ( Guallar Eliseo ) - Sungkyunkwan University SAIHST Department of Clinical Research Design and Evaluation
서지영 ( Suh Gee-Young ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Critical Care Medicine
정치량 ( Chung Chi-Ryang ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Critical Care Medicine

Abstract


Background: Despite the increasing importance of rehabilitation for critically ill patients, there is little information regarding how rehabilitation therapy is utilized in clinical practice. Our objectives were to evaluate the implementation rate of rehabilitation therapy in the intensive care unit (ICU) survivors and to investigate the effects of rehabilitation therapy on outcomes.

Methods: A retrospective nationwide cohort study with including > 18 years of ages admitted to ICU between January 2008 and May 2015 (n = 1,465,776). The analyzed outcomes were readmission to ICU readmission and emergency room (ER) visit.

Results: During the study period, 249,918 (17.1%) patients received rehabilitation therapy. The percentage of patients receiving any rehabilitation therapy increased annually from 14% in 2008 to 20% in 2014, and the percentages for each type of therapy also increased over time. The most common type of rehabilitation was physical therapy (91.9%), followed by neuromuscular electrical stimulation (29.6%), occupational (28.6%), respiratory, (11.6%) and swallowing (10.3%) therapies. After adjusting for confounding variables, the risk of 30-day ICU readmission was lower in patients who received rehabilitation therapy than in those who did not (P < 0.001; hazard ratio [HR], 0.70; 95% confidence interval [CI], 0.65?0.75). And, the risk of 30-day ER visit was also lower in patients who received rehabilitation therapy (P < 0.001; HR, 0.83; 95% CI, 0.77?0.88).

Conclusion: In this nationwide cohort study in Korea, only 17% of all ICU patients received rehabilitation therapy. However, rehabilitation is associated with a significant reduction in the risk of 30-day ICU readmission and ER visit.

키워드

Nationwide Cohort Study; Intensive Care Units; Survivors; Rehabilitation; Readmission
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