Effect of Integrated Multidisciplinary Rehabilitation in a High-Dependency Unit on Outcomes of Patients With Post-Intensive Care Syndrome: A Prospective Interventional Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 250
- 试验地点
- 1
- 主要终点
- Change in Physical Function (CPAx Score)
研究概览
简要总结
Post-intensive care syndrome (PICS) is characterized by persistent physical, cognitive, and psychological impairments among survivors of critical illness. Although advances in intensive care medicine have reduced mortality, a large proportion of ICU survivors experience long-term functional impairments after discharge.
High-dependency units (HDUs) serve as transitional care settings between intensive care units and general wards. Many critically ill survivors who cannot directly return home are transferred to HDU for continued treatment and rehabilitation. However, evidence regarding systematic multidisciplinary rehabilitation interventions in HDU settings remains limited.
This prospective single-center interventional study aims to evaluate the effects of an integrated multidisciplinary rehabilitation model implemented in the HDU on physical, cognitive, and psychological outcomes among patients with post-intensive care syndrome. All enrolled patients will receive standardized integrated medical, nursing, and rehabilitation interventions. Multidimensional functional assessments will be conducted at baseline, during hospitalization, and before discharge from the HDU.
详细描述
Post-intensive care syndrome (PICS) includes physical weakness, cognitive impairment, and psychological disorders that occur after critical illness. Previous studies have shown that 50-70% of ICU survivors develop at least one PICS-related impairment within 6-12 months after discharge.
Current interventions mainly focus on ICU-based strategies such as the ABCDEF bundle, which can improve short-term outcomes but may not adequately address long-term functional recovery. Many patients remain severely debilitated after ICU discharge and require transitional care.
The high-dependency unit (HDU) represents a potential critical window for early rehabilitation intervention. Patients in this stage often have multiple functional impairments but remain medically stable enough to participate in rehabilitation programs.
This study will enroll patients transferred from ICU to HDU who meet diagnostic criteria for PICS. Participants will receive an integrated multidisciplinary intervention including medical management, respiratory rehabilitation, physical rehabilitation, nursing care, and cognitive-psychological support.
Functional assessments will be conducted at baseline, every two weeks during hospitalization, and prior to HDU discharge. The study will evaluate changes in physical, cognitive, and psychological outcomes associated with this intervention.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥18 years
- •Diagnosed with post-intensive care syndrome
- •Transferred from ICU to HDU
- •Available paired admission and discharge data
排除标准
- •Death within 24 hours after HDU admission
- •Missing primary outcome data
研究组 & 干预措施
Integrated Multidisciplinary Rehabilitation in HDU
Participants transferred from the intensive care unit (ICU) to the high-dependency unit (HDU) who meet the diagnostic criteria for post-intensive care syndrome (PICS) will receive an integrated multidisciplinary rehabilitation program during their HDU stay.
The intervention includes coordinated medical management, respiratory rehabilitation, physical rehabilitation, rehabilitation nursing, and cognitive and psychological interventions delivered by a multidisciplinary team.
干预措施: Integrated Multidisciplinary Rehabilitation (Behavioral)
结局指标
主要结局
Change in Physical Function (CPAx Score)
时间窗: Baseline (within 48 hours after HDU admission) and at HDU discharge，assessed up to 2 days
Change in Chelsea Critical Care Physical Assessment Tool (CPAx) score from baseline to HDU discharge. The CPAx score ranges from 0 to 50, with higher scores indicating better physical function.
次要结局
未报告次要终点
研究者
Hongying Jiang, MD
Sponsor-Investigator
Capital Medical University