Early goal-directed mobilization in patients with acute type A aortic dissection: A randomized controlled trial.
Clin Rehabil 2023;
37:1311-1321. [PMID:
37070198 DOI:
10.1177/02692155231169822]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE
To determine the safety and efficacy of early postoperative mobilization in patients who have undergone surgical repair of acute type A aortic dissection.
DESIGN
Randomized controlled trial.
SETTING
Heart Medical Center.
SUBJECTS
Seventy-seven patients with acute type A aortic dissection were assessed.
INTERVENTION
Patients were randomly allocated into: (1) the control group (usual care) (n = 38) and (2) the intervention group (early goal-directed mobilization) (n = 39).
MAIN MEASURES
The primary outcome was the patient's functional status. The secondary outcomes included vital signs, serious adverse events, muscle strength, intensive care unit-acquired weakness, grip strength, duration of mechanical ventilation, length of stay, readmission rate, and health-related quality of life after 3 months.
RESULTS
The vital signs of the patients were within the tolerable ranges during the entire intervention. No serious exercise-related adverse events were observed in the intervention group. The Barthel Index score (P = 0.013), Medical Research Council score (P = 0.001), grip strength (P = 0.001), and health-related quality of life (P = 0.001) were higher in the intervention group. Intensive care unit acquired weakness (P = 0.019), duration of mechanical ventilation (P = 0.002), intensive care unit stay (P = 0.002), and total length of stay (P = 0.010) were lower in the intervention group. Patients in the intervention group had a higher physical health-related quality of life (P = 0.015) at 3 months post-surgery. There was no difference in readmission rates.
CONCLUSIONS
Delivery of early goal-directed mobilization in acute type A aortic dissection was safe and facilitated the recovery of daily living ability, shorter hospital stay, and improved quality of life after discharge.
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