首页|The Association Between Early Versus Late Physical Therapy Initiation and Outcomes of Trauma Patients With and Without Traumatic Brain Injuries
The Association Between Early Versus Late Physical Therapy Initiation and Outcomes of Trauma Patients With and Without Traumatic Brain Injuries
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NSTL
Elsevier
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
