Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/32964
Title: Responsiveness of Critically Ill Adults With Multimorbidity to Rehabilitation Interventions: A Patient-Level Meta-Analysis Using Individual Pooled Data From Four Randomized Trials.
Austin Authors: Jones, Jennifer R A ;Karahalios, Amalia;Puthucheary, Zudin A;Berry, Michael J;Files, D Clark;Griffith, David M;McDonald, Luke A ;Morris, Peter E;Moss, Marc;Nordon-Craft, Amy;Walsh, Timothy;Berney, Sue ;Denehy, Linda
Affiliation: Physiotherapy Department, The University of Melbourne, Parkville, Victoria, Australia.
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.
William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England, United Kingdom.;Adult Critical Care Unit, Royal London Hospital, Barts Health NHS Trust, London, England, United Kingdom.
Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC.
Pulmonary, Critical Care, Allergy and Immunologic Disease, Wake Forest University, Winston-Salem, NC.;Wake Forest Critical Illness Injury and Recovery Research Center, Wake Forest University, Winston Salem, NC.
Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, Edinburgh, United Kingdom.;Royal Infirmary of Edinburgh, NHS (National Health Service) Lothian, Edinburgh, Scotland, United Kingdom.
Physiotherapy Department, Division of Allied Health, Austin Health, Heidelberg, Victoria, Australia.
Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL.
Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO.
Physical Therapy Program, University of Colorado School of Medicine, Aurora, CO.
Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, Edinburgh, United Kingdom.;Anaesthetics, Critical Care, and Pain Medicine, School of Clinical Sciences, Queens Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom.;Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
Physiotherapy
Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia.;Allied Health, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Institute for Breathing and Sleep
Issue Date: 1-Oct-2023
Date: 2023
Publication information: Critical Care Medicine 2023-10-01; 51(10)
Abstract: To explore if patient characteristics (pre-existing comorbidity, age, sex, and illness severity) modify the effect of physical rehabilitation (intervention vs control) for the coprimary outcomes health-related quality of life (HRQoL) and objective physical performance using pooled individual patient data from randomized controlled trials (RCTs). Data of individual patients from four critical care physical rehabilitation RCTs. Eligible trials were identified from a published systematic review. Data sharing agreements were executed permitting transfer of anonymized data of individual patients from four trials to form one large, combined dataset. The pooled trial data were analyzed with linear mixed models fitted with fixed effects for treatment group, time, and trial. Four trials contributed data resulting in a combined total of 810 patients (intervention n = 403, control n = 407). After receiving trial rehabilitation interventions, patients with two or more comorbidities had HRQoL scores that were significantly higher and exceeded the minimal important difference at 3 and 6 months compared with the similarly comorbid control group (based on the Physical Component Summary score (Wald test p = 0.041). Patients with one or no comorbidities who received intervention had no HRQoL outcome differences at 3 and 6 months when compared with similarly comorbid control patients. No patient characteristic modified the physical performance outcome in patients who received physical rehabilitation. The identification of a target group with two or more comorbidities who derived benefits from the trial interventions is an important finding and provides direction for future investigations into the effect of rehabilitation. The multimorbid post-ICU population may be a select population for future prospective investigations into the effect of physical rehabilitation.
URI: https://ahro.austin.org.au/austinjspui/handle/1/32964
DOI: 10.1097/CCM.0000000000005936
ORCID: 
Journal: Critical Care Medicine
PubMed URL: 37246922
ISSN: 1530-0293
Type: Journal Article
Appears in Collections:Journal articles

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