Table 3.
Factors associated with time to initiating physical therapy in the medical intensive care unit
| Unadjusted* |
Adjusted |
|||||
|---|---|---|---|---|---|---|
| HR | 95% CI | P Value | HR | 95% CI | P Value | |
| Age, yr | 1.00 | 0.99–1.02 | 0.523 | |||
| Male | 0.90 | 0.62–1.31 | 0.576 | |||
| White (vs. nonwhite) | 1.33 | 0.92–1.93 | 0.134 | 1.14 | 0.78–1.68 | 0.496 |
| BMI ≥ 30 kg/m2 | 0.68 | 0.46–1.02 | 0.059 | 0.71 | 0.48–1.06 | 0.096 |
| Charlson comorbidity index | 0.91 | 0.83–0.98 | 0.020 | 0.97 | 0.91–1.04 | 0.400 |
| Functional comorbidity index | 1.04 | 0.93–1.16 | 0.471 | |||
| Admission during early rehabilitation | 7.03 | 4.40–11.22 | <0.001 | 8.38 | 4.98–14.11 | <0.001 |
| Source of ICU admission | ||||||
| Emergency room | 1.00 | |||||
| Ward | 1.02 | 0.63–1.65 | 0.945 | |||
| Other ICU | 1.34 | 0.54–3.32 | 0.525 | |||
| Other hospital | 1.28 | 0.76–2.14 | 0.351 | |||
| ICU admission diagnosis | ||||||
| Respiratory (including pneumonia) | 1.00 | |||||
| Sepsis/infectious disease | 0.84 | 0.53–1.33 | 0.453 | |||
| Gastrointestinal | 0.56 | 0.28–1.11 | 0.096 | |||
| Cardiovascular | 0.37 | 0.05–2.56 | 0.311 | |||
| Central nervous system | 1.33 | 0.29–6.22 | 0.714 | |||
| Other | 1.64 | 0.70–3.83 | 0.256 | |||
| APACHE II at ICU admission | 0.98 | 0.96–1.00 | 0.088 | 0.99 | 0.97–1.02 | 0.595 |
| Daily SOFA score | 0.90 | 0.87–0.93 | <0.001 | 0.93 | 0.89–0.97 | 0.001 |
| Daily mechanical ventilation status | 0.34 | 0.20–0.58 | <0.001 | 0.83 | 0.41–1.71 | 0.614 |
| FiO2 received (every 10% increase) | 0.69 | 0.62–0.78 | <0.001 | 0.86 | 0.75–0.99 | 0.038 |
| PEEP | 0.86 | 0.82–0.90 | <0.001 | 0.99 | 0.91–1.08 | 0.812 |
| Benzodiazepine infusion | 0.23 | 0.15–0.35 | <0.001 | 0.90 | 0.44–1.86 | 0.778 |
| Opioid infusion | 0.25 | 0.16–0.37 | <0.001 | 0.47 | 0.25–0.89 | 0.021 |
| Sedation status† | ||||||
| Awake | 1.00 | 1.00 | ||||
| Light sedation | 0.56 | 0.27–1.16 | 0.109 | 0.66 | 0.41–1.04 | 0.077 |
| Deep sedation/comatose | 0.09 | 0.05–0.17 | <0.001 | 0.24 | 0.12–0.46 | <0.001 |
Definition of abbreviations: APACHE II = Acute Physiology and Chronic Health Evaluation II; BMI = body mass index; CI = confidence interval; HR = hazard ratio; ICU = intensive care unit; PEEP = positive end-expiratory pressure; SOFA = Sequential Organ Failure Assessment.
HRs greater than 1 are interpreted as the variable being associated with earlier initiation of active physical therapy in the MICU. HRs were calculated using Fine and Gray regression models (63), with daily time-varying exposures for SOFA score, mechanical ventilation status, FiO2, PEEP, benzodiazepine infusion, opioid infusion, and sedation status.
Patient sedation status was classified as follows: awake (RASS ≥ −1), lightly sedated (RASS, −2 or −3), or deeply sedated/comatose (RASS, −4 or −5).