Association between Early Mobilization in the ICU and Psychiatric Symptoms after Surviving a Critical Illness: A Multi-Center Prospective Cohort Study
This is a prospective multicenter cohort study aiming to investigate the association between early mobilization (EM), defined as a rehabilitation level of sitting at the edge of the bed or higher within 72 h of ICU admission, and psychiatric outcome. Consecutive patients, admitted to the ICU for mor...
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| Veröffentlicht in: | Journal of clinical medicine 2022-05, Vol.11 (9), p.2587 |
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| creator | Watanabe, Shinichi Liu, Keibun Nakamura, Kensuke Kozu, Ryo Horibe, Tatsuya Ishii, Kenzo Yasumura, Daisetsu Takahashi, You Nanba, Tomoya Morita, Yasunari Kanaya, Takahiro Suzuki, Shuichi Lefor, Alan Kawarai Katsukawa, Hajime Kotani, Toru |
| description | This is a prospective multicenter cohort study aiming to investigate the association between early mobilization (EM), defined as a rehabilitation level of sitting at the edge of the bed or higher within 72 h of ICU admission, and psychiatric outcome. Consecutive patients, admitted to the ICU for more than 48 h, were enrolled. The primary outcome was the incidence of psychiatric symptoms at 3 months after hospital discharge defined as the presence of any of three symptoms: depression, anxiety, or post-traumatic stress disorder (PTSD). Risk ratio (RR) and multiple logistic regression analysis were used. As a sensitivity analysis, two methods for inverse probability of treatment weighting statistics were performed. Of the 192 discharged patients, 99 (52%) were assessed. The patients who achieved EM had a lower incidence of psychiatric symptoms compared to those who did not (25% vs. 51%,
-value 0.008, odds ratio (OR) 0.27, adjusted
= 0.032). The RR for psychiatric symptoms in the EM group was 0.49 [95% Confidence Interval, 0.29-0.83]. Sensitivity analysis accounting for the influence of death, loss to follow-up (OR 0.28, adjusted
= 0.008), or potential confounders (OR 0.49, adjusted
= 0.046) consistently showed a lower incidence of psychiatric symptoms in the EM group. EM was consistently associated with fewer psychiatric symptoms. |
| doi_str_mv | 10.3390/jcm11092587 |
| format | Article |
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-value 0.008, odds ratio (OR) 0.27, adjusted
= 0.032). The RR for psychiatric symptoms in the EM group was 0.49 [95% Confidence Interval, 0.29-0.83]. Sensitivity analysis accounting for the influence of death, loss to follow-up (OR 0.28, adjusted
= 0.008), or potential confounders (OR 0.49, adjusted
= 0.046) consistently showed a lower incidence of psychiatric symptoms in the EM group. EM was consistently associated with fewer psychiatric symptoms.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm11092587</identifier><identifier>PMID: 35566716</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Anesthesia ; Anxiety ; Clinical medicine ; Cohort analysis ; Delirium ; Hospitals ; Intensive care ; Mental disorders ; Patients ; Post traumatic stress disorder ; Questionnaires ; Range of motion ; Rehabilitation ; Ventilators ; Walking</subject><ispartof>Journal of clinical medicine, 2022-05, Vol.11 (9), p.2587</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-fc2aadf07a6fe50b8f01700f3dfdb8cc6cf4469e9ee506696b0debf14747c29a3</citedby><cites>FETCH-LOGICAL-c475t-fc2aadf07a6fe50b8f01700f3dfdb8cc6cf4469e9ee506696b0debf14747c29a3</cites><orcidid>0000-0001-8481-0294 ; 0000-0002-9310-185X ; 0000-0002-6867-1420 ; 0000-0001-6673-5630 ; 0000-0001-9504-0061 ; 0000-0003-2582-4324</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099642/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099642/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35566716$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watanabe, Shinichi</creatorcontrib><creatorcontrib>Liu, Keibun</creatorcontrib><creatorcontrib>Nakamura, Kensuke</creatorcontrib><creatorcontrib>Kozu, Ryo</creatorcontrib><creatorcontrib>Horibe, Tatsuya</creatorcontrib><creatorcontrib>Ishii, Kenzo</creatorcontrib><creatorcontrib>Yasumura, Daisetsu</creatorcontrib><creatorcontrib>Takahashi, You</creatorcontrib><creatorcontrib>Nanba, Tomoya</creatorcontrib><creatorcontrib>Morita, Yasunari</creatorcontrib><creatorcontrib>Kanaya, Takahiro</creatorcontrib><creatorcontrib>Suzuki, Shuichi</creatorcontrib><creatorcontrib>Lefor, Alan Kawarai</creatorcontrib><creatorcontrib>Katsukawa, Hajime</creatorcontrib><creatorcontrib>Kotani, Toru</creatorcontrib><title>Association between Early Mobilization in the ICU and Psychiatric Symptoms after Surviving a Critical Illness: A Multi-Center Prospective Cohort Study</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>This is a prospective multicenter cohort study aiming to investigate the association between early mobilization (EM), defined as a rehabilitation level of sitting at the edge of the bed or higher within 72 h of ICU admission, and psychiatric outcome. Consecutive patients, admitted to the ICU for more than 48 h, were enrolled. The primary outcome was the incidence of psychiatric symptoms at 3 months after hospital discharge defined as the presence of any of three symptoms: depression, anxiety, or post-traumatic stress disorder (PTSD). Risk ratio (RR) and multiple logistic regression analysis were used. As a sensitivity analysis, two methods for inverse probability of treatment weighting statistics were performed. Of the 192 discharged patients, 99 (52%) were assessed. The patients who achieved EM had a lower incidence of psychiatric symptoms compared to those who did not (25% vs. 51%,
-value 0.008, odds ratio (OR) 0.27, adjusted
= 0.032). The RR for psychiatric symptoms in the EM group was 0.49 [95% Confidence Interval, 0.29-0.83]. Sensitivity analysis accounting for the influence of death, loss to follow-up (OR 0.28, adjusted
= 0.008), or potential confounders (OR 0.49, adjusted
= 0.046) consistently showed a lower incidence of psychiatric symptoms in the EM group. EM was consistently associated with fewer psychiatric symptoms.</description><subject>Anesthesia</subject><subject>Anxiety</subject><subject>Clinical medicine</subject><subject>Cohort analysis</subject><subject>Delirium</subject><subject>Hospitals</subject><subject>Intensive care</subject><subject>Mental disorders</subject><subject>Patients</subject><subject>Post traumatic stress disorder</subject><subject>Questionnaires</subject><subject>Range of motion</subject><subject>Rehabilitation</subject><subject>Ventilators</subject><subject>Walking</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpdkUFr3DAUhE1paUKaU-9F0EshuJEsW7J6KCwmbRcSGtjmbGT5KatFlraSvMX9If299bJJ2ESXJ5jvDSNNlr0n-DOlAl9u1EAIFkVV81fZaYE5zzGt6euj-0l2HuMGz6euy4Lwt9kJrSrGOGGn2b9FjF4ZmYx3qIP0B8ChKxnshG58Z6z5e5CMQ2kNaNncIel6dBsntZ63glFoNQ3b5IeIpE4Q0GoMO7Mz7h5J1ASTjJIWLa11EOMXtEA3o00mb8Dt4dvg4xZUMjtAjV_7kNAqjf30LnujpY1w_jDPsrtvV7-aH_n1z-_LZnGdq5JXKdeqkLLXmEumocJdrTHhGGva676rlWJKlyUTIGBWGROswz10mpS85KoQkp5lXw--27EboFdzqiBtuw1mkGFqvTTtc8WZdXvvd63AQrCymA0-PRgE_3uEmNrBRAXWSgd-jG3BWFnjgtBqRj--QDd-DG5-3p6imJBS7KmLA6Xmr4kB9FMYgtt95e1R5TP94Tj_E_tYMP0P4suqhw</recordid><startdate>20220505</startdate><enddate>20220505</enddate><creator>Watanabe, Shinichi</creator><creator>Liu, Keibun</creator><creator>Nakamura, Kensuke</creator><creator>Kozu, Ryo</creator><creator>Horibe, Tatsuya</creator><creator>Ishii, Kenzo</creator><creator>Yasumura, Daisetsu</creator><creator>Takahashi, You</creator><creator>Nanba, Tomoya</creator><creator>Morita, Yasunari</creator><creator>Kanaya, Takahiro</creator><creator>Suzuki, Shuichi</creator><creator>Lefor, Alan Kawarai</creator><creator>Katsukawa, Hajime</creator><creator>Kotani, Toru</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8481-0294</orcidid><orcidid>https://orcid.org/0000-0002-9310-185X</orcidid><orcidid>https://orcid.org/0000-0002-6867-1420</orcidid><orcidid>https://orcid.org/0000-0001-6673-5630</orcidid><orcidid>https://orcid.org/0000-0001-9504-0061</orcidid><orcidid>https://orcid.org/0000-0003-2582-4324</orcidid></search><sort><creationdate>20220505</creationdate><title>Association between Early Mobilization in the ICU and Psychiatric Symptoms after Surviving a Critical Illness: A Multi-Center Prospective Cohort Study</title><author>Watanabe, Shinichi ; 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Consecutive patients, admitted to the ICU for more than 48 h, were enrolled. The primary outcome was the incidence of psychiatric symptoms at 3 months after hospital discharge defined as the presence of any of three symptoms: depression, anxiety, or post-traumatic stress disorder (PTSD). Risk ratio (RR) and multiple logistic regression analysis were used. As a sensitivity analysis, two methods for inverse probability of treatment weighting statistics were performed. Of the 192 discharged patients, 99 (52%) were assessed. The patients who achieved EM had a lower incidence of psychiatric symptoms compared to those who did not (25% vs. 51%,
-value 0.008, odds ratio (OR) 0.27, adjusted
= 0.032). The RR for psychiatric symptoms in the EM group was 0.49 [95% Confidence Interval, 0.29-0.83]. Sensitivity analysis accounting for the influence of death, loss to follow-up (OR 0.28, adjusted
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| subjects | Anesthesia Anxiety Clinical medicine Cohort analysis Delirium Hospitals Intensive care Mental disorders Patients Post traumatic stress disorder Questionnaires Range of motion Rehabilitation Ventilators Walking |
| title | Association between Early Mobilization in the ICU and Psychiatric Symptoms after Surviving a Critical Illness: A Multi-Center Prospective Cohort Study |
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