Joint contractures in the intensive care unit: association with resource utilization and ambulatory status at discharge

被引:21
作者
Clavet, Heidi [1 ,2 ]
Hebert, Paul C. [2 ,3 ]
Fergusson, Dean A. [2 ,3 ]
Doucette, Steve [2 ]
Trudel, Guy [1 ,3 ]
机构
[1] Univ Ottawa, Bone & Joint Lab, Ottawa, ON, Canada
[2] Ottawa Hosp, OHRI, Clin Epidemiol Program, Ottawa, ON, Canada
[3] Univ Ottawa, Fac Med, Ottawa, ON, Canada
基金
加拿大健康研究院;
关键词
Joint contractures; intensive care unit; resource utilization; KNEE FLEXION CONTRACTURES; RESPIRATORY-FAILURE; CRITICALLY-ILL; CRITICAL ILLNESS; EARLY MOBILITY; PHYSIOTHERAPY; OUTCOMES; PATIENT; ICU; IMMOBILIZATION;
D O I
10.3109/09638288.2010.486468
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Method. Data on ICU joint contractures were extracted from an existing contracture database containing information on 155 Canadian patients with a tertiary ICU stay of 14 days or more. Results. Of 155 patients, 115 (74.2%) received a range of motion assessment in the ICU. The assessment took place a median of 7 days (IQR 0-36) after ICU admission. Significantly fewer patients with joint contractures than without joint contractures were mobilized on the hospital ward (21/38 [55.3%] vs. 27/34 [79.4%], P = 0.03). At discharge home, more patients with joint contractures had a low ambulatory status (38 [64.4%]) compared with patients without joint contractures (26 [51.0%]; P = 0.002). Conclusion. The median delay of 7 days before musculoskeletal assessment in the ICU together with failure to assess 26% of patients may have allowed the development of contractures, which affected the patients' ambulatory status at discharge from hospital.
引用
收藏
页码:105 / 112
页数:8
相关论文
共 43 条
[1]   Walker-assisted gait in rehabilitation: A study of biomechanics and instrumentation [J].
Bachschmidt, RA ;
Harris, GF ;
Simoneau, GG .
IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING, 2001, 9 (01) :96-105
[2]  
BAILEY P, 2000, INTENS CARE MED, V26, P988
[3]   Early activity is feasible and safe in respiratory failure patients [J].
Bailey, Polly ;
Thomsen, George E. ;
Spuhler, Vicki J. ;
Blair, Robert ;
Jewkes, James ;
Bezdjian, Louise ;
Veale, Kristy ;
Rodriquez, Larissa ;
Hopkins, Ramona O. .
CRITICAL CARE MEDICINE, 2007, 35 (01) :139-145
[4]   Static progressive stretch for the treatment of knee stiffness [J].
Bonutti, Peter M. ;
Mike, S. McGrath ;
Ulrich, Slif D. ;
McKenzie, Shelton A. ;
Seyler, Thorsten M. ;
Mont, Michael A. .
KNEE, 2008, 15 (04) :272-276
[5]  
Ceriana Piero, 2003, Respir Care, V48, P670
[6]   Patterns of chest physiotherapy in Australian Intensive Care Units [J].
Chaboyer, W ;
Gass, E ;
Foster, M .
JOURNAL OF CRITICAL CARE, 2004, 19 (03) :145-151
[7]  
Chaboyer Wendy, 2002, Aust Crit Care, V15, P21, DOI 10.1016/S1036-7314(02)80040-6
[8]   Joint contracture following prolonged stay in the intensive care unit [J].
Clavet, Heidi ;
Hebert, Paul C. ;
Fergusson, Dean ;
Doucette, Steve ;
Trudel, Guy .
CANADIAN MEDICAL ASSOCIATION JOURNAL, 2008, 178 (06) :691-697
[9]  
DITTMER DK, 1993, CAN FAM PHYSICIAN, V39, P1428
[10]  
Farmer SE, 2001, DISABIL REHABIL, V23, P549