Early Rehabilitation and In-Hospital Mortality in Intensive Care Patients With Community-Acquired Pneumonia.

Abstract

Community-acquired pneumonia is one of the most common infectious diseases and can be fatal. The benefits of early rehabilitation in intensive care units are known, but the association between early rehabilitation and in-hospital mortality of patients with community-acquired pneumonia admitted to intensive care units has not been studied. To study the association between early rehabilitation and the in-hospital mortality of patients with community- acquired pneumonia admitted to intensive care units, effects of early rehabilitation on unit and hospital lengths of stay, and total costs of hospitalization. A retrospective observational cohort study using a national inpatient database of patients with community-acquired pneumonia admitted to intensive care units in acute care hospitals in Japan from July 2011 through March 2014. Propensity score-matching analysis was used to compare outcomes between patients with and without early rehabilitation (within 2 days of admission). Among 8732 eligible patients, propensity score matching created 972 pairs of patients with and without early rehabilitation. The early rehabilitation group had significantly lower in-hospital mortality than did the group without early rehabilitation (17.9% vs 21.9%, respectively; P = .03). The groups did not differ significantly in intensive care unit or hospital lengths of stay or in total costs of hospitalization. Early rehabilitation within 2 days of admission was associated with reduced in-hospital mortality of patients with community-acquired pneumonia admitted to intensive care units.