Abstract
Background: There is a lack of literature regarding the most effective timing to initiate phys-ical therapy (PT) among traumatically injured patients. We aim to evaluate the association between early PT/mobilization versus delayed or late PT/mobilization and clinical outcomes of trauma patients. Methods: A retrospective cohort analysis of an urban level-I trauma center from 2014 to 2019 was performed. Univariate analyses and multivariable logistic regression were performed with significance defined as P < 0.05. Results: A total of 11,937 patients were analyzed. Among patients without a traumatic brain injury (TBI), late PT initiation times were associated with 60% lower odds of being discharged home without services ( P < 0.05), significantly increased hospital and ICU length of stay (H -LOS, ICU-LOS) ( P < 0.05), and significantly higher odds of complications (VTE, pneumonia, pressure ulcers, ARDS) ( P < 0.001). Among patients with a TBI, late PT initiation time had 76% lower odds of being discharged home without services ( P < 0.05) and significantly longer H-LOS and ICU-LOS ( P < 0.05) however did not experience significantly higher odds of com-plications ( P > 0.05). Conclusions: Among traumatically injured patients, early PT is associated with decreased odds of complications, shorter H-LOS and ICU-LOS, and a favorable discharge disposition to home without services. Adoption of early PT initiation/mobilization protocols and establish-ment of prophylactic measures against complications associated with delayed PT is critical to maximize quality of care and trauma patient outcomes. Multi-center prospective studies are needed to ascertain the impact of PT initiation times in greater detail and to minimize trauma patient morbidity. (c) 2021 Published by Elsevier Inc.
NSTL
Elsevier