Patient Characteristics and Acute PT and OT Utilization During the Initial Surge of COVID-19: A Retrospective Observational Study.

IF 0.5 Q4 REHABILITATION Journal of Acute Care Physical Therapy Pub Date : 2022-01-01 Epub Date: 2021-04-20 DOI:10.1097/JAT.0000000000000163
Adele Myszenski, Romina Bello, Cynthia Melican, Nanette Pfitzenmaier
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Abstract

Objective: To describe the characteristics of patients and investigate the utilization of physical (PT) and occupational therapy (OT) intervention for those with a positive coronavirus disease-2019 (COVID-19) diagnosis compared with other patient populations during the first 6 weeks of the novel coronavirus pandemic.

Methods: A retrospective, observational study of adult inpatients with a length of stay of 1 or more days at an urban hospital in Detroit, Michigan. Individuals with a COVID-19 diagnosis were compared with a cohort within similar diagnostic categories (respiratory, fever, and sepsis) but without COVID-19. Outcome measures included PT or OT intervention on 1 or more days, the timing of initial PT or OT visit, the average number of visits and units per patient, length of stay, discharge to home, and readmission within 30 days.

Results: Individuals with COVID-19 had lower rates of discharge to home (P = .001), higher rates of readmission within 30 days of hospital discharge (P = .01), increased hospital length of stay (P = .001), and waited an average of 3.1 days longer for therapy evaluations than subjects in the comparison group (P = .001). The percentage of subjects who had one or more PT or OT visits during their hospital stays was comparable between groups. Once therapy was initiated, the average number of visits per patient and dosing of units in 15-minute increments were similar between the 2 groups.

Conclusions: Patients acutely ill with COVID-19 hospitalized with the virus during the first 6 weeks of the pandemic remained in the intensive care unit and hospital longer than their counterparts without COVID-19 and had a delay in initiation of PT and OT intervention. PT and OT are important members of the care team for patients with the novel coronavirus. Understanding the descriptive characteristics of patients and therapy services during the initial surge could help improve utilization and patient outcomes.

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COVID-19 最初涌现期间的患者特征与急性 PT 和 OT 使用情况:回顾性观察研究。
目的描述在新型冠状病毒大流行的头 6 周内,与其他患者相比,冠状病毒病-2019(COVID-19)诊断呈阳性的患者的特征,并调查他们使用物理治疗(PT)和职业治疗(OT)干预的情况:对密歇根州底特律市一家城市医院住院时间为 1 天或 1 天以上的成年住院患者进行回顾性观察研究。将诊断出 COVID-19 的患者与诊断类别相似(呼吸道、发烧和败血症)但未诊断出 COVID-19 的患者进行比较。结果测量包括 1 天或 1 天以上的物理治疗或 OT 干预、首次物理治疗或 OT 访问的时间、每位患者的平均访问次数和单位、住院时间、出院回家时间以及 30 天内的再次入院时间:结果:COVID-19 患者出院回家的比例较低(P = .001),出院后 30 天内再次入院的比例较高(P = .01),住院时间较长(P = .001),接受治疗评估的平均等待时间比对比组患者长 3.1 天(P = .001)。两组受试者在住院期间接受过一次或多次物理治疗或作业治疗的比例相当。一旦开始治疗,每名患者的平均就诊次数和以 15 分钟为单位的剂量在两组之间相似:结论:在大流行的前 6 周,因感染 COVID-19 病毒而住院的急性期患者在重症监护室和医院的留院时间比未感染 COVID-19 病毒的患者要长,而且开始进行 PT 和 OT 干预的时间也有所延迟。PT 和 OT 是新型冠状病毒患者护理团队的重要成员。了解患者和治疗服务在最初激增期间的描述性特征有助于提高利用率和改善患者预后。
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