Relationship between use of rehabilitation resources and ICU readmission and ER visits in ICU survivors: The Korean ICU national data study 2008-2015

Yun Hee Park, Ryoung Eun Ko, Danbee Kang, Jinkyeong Park, Kyeongman Jeon, Jeong Hoon Yang, Chi Min Park, Joongbum Cho, Young Sook Park, Hyejung Park, Juhee Cho, Eliseo Guallar, Gee Young Suh, Chi Ryang Chung

Research output: Contribution to journalArticle

Abstract

Background: Despite the increasing importance of rehabilitation for critically ill patients, there is little information regarding how rehabilitation therapy is utilized in clinical practice. Our objectives were to evaluate the implementation rate of rehabilitation therapy in the intensive care unit (ICU) survivors and to investigate the effects of rehabilitation therapy on outcomes. Methods: A retrospective nationwide cohort study with including > 18 years of ages admitted to ICU between January 2008 and May 2015 (n = 1,465,776). The analyzed outcomes were readmission to ICU readmission and emergency room (ER) visit. Results: During the study period, 249,918 (17.1%) patients received rehabilitation therapy. The percentage of patients receiving any rehabilitation therapy increased annually from 14% in 2008 to 20% in 2014, and the percentages for each type of therapy also increased over time. The most common type of rehabilitation was physical therapy (91.9%), followed by neuromuscular electrical stimulation (29.6%), occupational (28.6%), respiratory, (11.6%) and swallowing (10.3%) therapies. After adjusting for confounding variables, the risk of 30-day ICU readmission was lower in patients who received rehabilitation therapy than in those who did not (P < 0.001; hazard ratio [HR], 0.70; 95% confidence interval [CI], 0.65-0.75). And, the risk of 30-day ER visit was also lower in patients who received rehabilitation therapy (P < 0.001; HR, 0.83; 95% CI, 0.77-0.88). Conclusion: In this nationwide cohort study in Korea, only 17% of all ICU patients received rehabilitation therapy. However, rehabilitation is associated with a significant reduction in the risk of 30-day ICU readmission and ER visit.

Original languageEnglish (US)
Article numberE101
JournalJournal of Korean Medical Science
Volume35
Issue number15
DOIs
StatePublished - Apr 1 2020

Keywords

  • Intensive care units
  • Nationwide cohort study
  • Readmission
  • Rehabilitation
  • Survivors

ASJC Scopus subject areas

  • Medicine(all)

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    Park, Y. H., Ko, R. E., Kang, D., Park, J., Jeon, K., Yang, J. H., Park, C. M., Cho, J., Park, Y. S., Park, H., Cho, J., Guallar, E., Suh, G. Y., & Chung, C. R. (2020). Relationship between use of rehabilitation resources and ICU readmission and ER visits in ICU survivors: The Korean ICU national data study 2008-2015. Journal of Korean Medical Science, 35(15), [E101]. https://doi.org/10.3346/JKMS.2020.35.E101