PP146 - ASSOCIATION OF EARLY REHABILITATION WITH FUNCTIONAL RECOVERY AND IN-HOSPITAL MORTALITY IN ICU PATIENTS RECEIVING EARLY ENTERAL NUTRITION: A NATIONWIDE COHORT STUDY
PP146
ASSOCIATION OF EARLY REHABILITATION WITH FUNCTIONAL RECOVERY AND IN-HOSPITAL MORTALITY IN ICU PATIENTS RECEIVING EARLY ENTERAL NUTRITION: A NATIONWIDE COHORT STUDY
H. Murata1,2,*, K. Maeda3,4, F. Kawase5, A. Nagano6, J. Ueshima7, S. Miyahara4, Y. Saino8, K. Murotani9,10, T. Inoue11
1Faculty of Health Science, Kyorin University, Mitaka, Japan, 2Department of Physiotherapy and Environmental Health, Tartu Applied Health Sciences University, Tartu, Estonia, 3Nutrition Therapy Support Center, Aichi Medical University Hospital, Nagakute, 4Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, 5Department of Sports and Health Sciences, Graduate School of Biomedical Engineering, Tohoku University, Sendai, 6Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, 7Department of Nutritional Service, NTT Medical Center, Shinagawa, 8Department of Clinical Nutrition, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, 9School of Medical Technology, Kurume University, 10Biostatistics Center, Kurune University, Kurume, 11Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
Rationale: Early enteral nutrition within 48 h is recommended in critically ill patients, but the benefit of early rehabilitation in patients receiving early enteral nutrition remains unclear. We investigated the association between early rehabilitation and outcomes in patients admitted to the intensive care unit (ICU) who received early enteral nutrition.
Methods: This retrospective cohort study used a nationwide administrative database in Japan. Patients admitted to the ICU with a recorded Sequential Organ Failure Assessment score on hospital day 1 who initiated oral intake or enteral feeding on day 1 or 2 were included. Patients with a length of stay of 7 days or fewer or missing Barthel Index (BI) were excluded. Early rehabilitation was defined as rehabilitation initiated on day 1 or 2, whereas late rehabilitation included patients in whom rehabilitation was initiated on day 3 or later or not provided. Stabilized inverse probability of treatment weighting (IPTW) was applied. Outcomes were BI at discharge, BI ≥60 at discharge, in-hospital complications, and 60-day competing-risk outcomes.
Results: A total of 7,842 patients were included (early rehabilitation: 4,093; late rehabilitation: 3,749). After IPTW, early rehabilitation was associated with a higher BI at discharge (mean difference 4.99, 95% confidence interval [CI] 3.16-6.81) and greater odds of BI ≥60 at discharge (odds ratio 1.21, 95% CI 1.09-1.34). Early rehabilitation was also associated with lower in-hospital mortality within 60 days (subdistribution hazard ratio 0.72, 95% CI 0.65-0.80). In-hospital complications and discharge alive within 60 days did not differ significantly between groups.
Conclusion: In ICU patients receiving early enteral nutrition, early rehabilitation was associated with better function and lower in-hospital mortality.
Disclosure of Interest: None declared