Background: Timely initiation of physical, occupational, and speech therapy in critically ill patients is crucial to\nreduce morbidity and improve outcomes. Over a 5-year time interval, we sought to determine the utilization of\nthese rehabilitation therapies in the USA.\nMethods: We performed a retrospective cohort study utilizing a large, national administrative database including\nICU patients from 591 hospitals. Patients over 18 years of age with acute respiratory failure requiring invasive\nmechanical ventilation within the first 2 days of hospitalization and for a duration of at least 48 h were included.\nResults: A total of 264,137 patients received invasive mechanical ventilation for a median of 4.0 [2.0-8.0] days.\nOverall, patients spent a median of 5.0 [3.0-10.0] days in the ICU and 10.0 [7.0-16.0] days in the hospital. During\ntheir hospitalization, 66.5%, 41.0%, and 33.2% (95% CI = 66.3-66.7%, 40.8-41.2%, 33.0-33.4%, respectively) received\nphysical, occupational, and speech therapy. While on mechanical ventilation, 36.2%, 29.7%, and 29.9% (95% CI = 36.\n0-36.4%, 29.5-29.9%, 29.7-30.1%) received physical, occupational, and speech therapy. In patients receiving therapy,\ntheir first physical therapy session occurred on hospital day 5 [3.0-8.0] and hospital day 6 [4.0-10.0] for occupational\nand speech therapy. Of all patients, 28.6% (95% CI = 28.4-28.8%) did not receive physical, occupational, or speech\ntherapy during their hospitalization. In a multivariate analysis, patients cared for in the Midwest and at teaching hospitals\nwere more likely to receive physical, occupational, and speech therapy (all P < 0.05). Of patients with identical covariates\nreceiving therapy, there was a median of 61%, 187%, and 70% greater odds of receiving physical, occupational, and\nspeech therapy, respectively, at one randomly selected hospital compared with another (median odds ratio 1.61, 2.87, 1.\n70, respectively).
Loading....