The Influence of COVID-19 on Patient Mobilization and Injury Attributes in the ICU: A Retrospective Analysis of a Level II Trauma Center.
Yelissa NavarroElizabeth HuangChandler E JohnsonForrest ClarkSamuel CoppolaSuraj ModiGordon L WarrenJarrod A CallPublished in: Trauma care (Basel, Switzerland) (2024)
The objectives of this study were to determine the effect of COVID-19 on physical therapy (PT) mobilization of trauma patients and to determine if mobilization affected patient course in the ICU. This retrospective study included patients who were admitted to the ICU of a level II trauma center. The patients were divided into two groups, i.e., those admitted before ( n = 378) and after ( n = 499) 1 April 2020 when Georgia's COVID-19 shelter-in-place order was mandated. The two groups were contrasted on nominal and ratio variables using Chi-square and Student's t -tests. A secondary analysis focused specifically on the after-COVID patients examined the extent to which mobilization ( n = 328) or lack of mobilization ( n = 171) influenced ICU outcomes (e.g., mortality, readmission). The two groups were contrasted on nominal and ratio variables using Chi-square and Student's t -tests. The after-COVID patients had higher injury severity as a greater proportion was classified as severely injured (i.e., >15 on Injury Severity Score) compared to the before-COVID patients. After-COVID patients also had a greater cumulative number of comorbidities and experienced greater complications in the ICU. Despite this, there was no difference between patients in receiving a PT consultation or days to mobilization. Within the after-COVID cohort, those who were mobilized were older, had greater Glasgow Coma Scale scores, had longer total hospital days, and had a lesser mortality rate, and a higher proportion were female. Despite shifting patient injury attributes post-COVID-19, a communicable disease, mobilization care remained consistent and effective.
Keyphrases
- sars cov
- coronavirus disease
- intensive care unit
- end stage renal disease
- trauma patients
- respiratory syndrome coronavirus
- ejection fraction
- newly diagnosed
- mechanical ventilation
- healthcare
- chronic kidney disease
- palliative care
- case report
- cardiovascular disease
- cardiovascular events
- emergency department
- physical activity
- peritoneal dialysis
- metabolic syndrome
- skeletal muscle
- middle aged
- patient reported
- adipose tissue
- insulin resistance
- coronary artery disease
- quality improvement