Age and period of ventilator use are related to walking independence at the time of discharge in patients with severe COVID-19 pneumonia: a single-center retrospective observational study.
Kento Kaneko, Masahiro Ishizaka, Kouhei Chiba and 4 others
PMID 38434997WHAT IT FOUND
In patients with severe COVID-19 pneumonia who were previously independent walkers, older age and longer ventilator use predicted whether they could walk unaided at discharge.
The cutoffs for likely dependence were age 56 years and 7.5 days on the ventilator.
Key findings
01Age and duration of ventilator use were the two independent factors predicting whether patients could walk independently at discharge.
02The study identified cutoff values of 56 years for age and 7.5 days for ventilator use as thresholds associated with loss of independent ambulation.
03Patients who failed to regain independent walking had significantly longer durations from the start of therapy to standing and walking compared to those who did.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was conducted at a single center, which may limit generalizability to other healthcare systems. It is a retrospective design, relying on existing medical records which may have missing or inconsistent data. The authors noted that some patients had very short physical therapy durations due to pandemic-related transfers to local hospitals, potentially confounding the relationship between therapy intensity and outcome. The study did not compare these outcomes to non-COVID-19 ICU patients, so it is unclear if these predictors are specific to COVID-19 or apply to general ICU-acquired weakness. The cutoff for ventilator use (7.5 days) had low specificity (23.7%), meaning it is not a highly precise tool for individual patient prediction.
Declared interests
The authors declared no conflicts of interest and no specific funding sources were mentioned in the provided text.
The easy way to misread this
Do not interpret the age and ventilator duration cutoffs as definitive diagnostic thresholds for individual patients. The model correctly classified 78.6% of cases, meaning over 20% were misclassified, and the ventilator duration cutoff had very low specificity. These factors are probabilistic predictors in a specific population, not certainties.