Evidence map›Paper›PMID 40739567›Full record

ArticleCritical care (London, England)2025

Effect of a generalized early mobilization and rehabilitation protocol on outcomes in trauma patients admitted to the intensive care unit: a retrospective pre-post study.

Tsuyoshi Ichikawa, Asuka Tsuchiya, Yusuke Tsutsumi, Tatsuya Okawa, Daisuke Kubo, Yu Horimizu, Ryo Tsutsui, Hina Shukumine, Kento Noda, Katsuhiro Mizuno

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In one paragraph

Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Tsuyoshi IchikawaDepartment of Rehabilitation Services, Tokai University Hospital, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan. tsuyottz727@tokai.ac.jp.
Asuka TsuchiyaDepartment of Emergency and Critical Care Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan. tsuchiya.asuka.t@tokai.ac.jp.
Yusuke TsutsumiDepartment of Emergency and Critical Care Medicine, National Hospital Organization Mito Medical Center, 280 Sakuranosato, Ibarakimachi, Higahi- Ibarakigun, Ibaraki, 311-3193, Japan.
Tatsuya OkawaDepartment of Rehabilitation Services, Tokai University Hospital, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
Daisuke KuboDepartment of Health Data Science, Yokohama City University, 22-2 Seto, Kanazawa-ku, Yokohama, 236-0027, Kanagawa, Japan.
Yu HorimizuDepartment of Rehabilitation Services, Tokai University Hospital, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
Ryo TsutsuiDepartment of Rehabilitation Services, Tokai University Hospital, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
Hina ShukumineDepartment of Rehabilitation Services, Tokai University Hospital, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
Kento NodaDepartment of Rehabilitation Services, Tokai University Hospital, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
Katsuhiro MizunoDepartment of Rehabilitation Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.

Funding

JSPS KAKENHI JP24H02726
6 · The paper itself

Abstract

backgroundThe impact of early mobilization and rehabilitation protocol (EMRP) on trauma patients admitted to the intensive care unit (ICU) remains unclear owing to limited randomized controlled trials and methodological limitations in observational studies. This study aimed to compare the clinical outcomes of trauma patients admitted to the ICU before and after EMRP implementation.

methodsA retrospective pre-post study was conducted on adult trauma patients having an Injury Severity Score ≥ 9 who were admitted to the ICU of a university hospital. Patients admitted from July 2021 to June 2022 comprised the pre-EMRP group, whereas those admitted from July 2022 to August 2023 comprised the post-EMRP group. Outcomes were compared between these two groups using propensity score matching to adjust for confounders. The primary outcome was the proportion of home discharge. The secondary outcomes were the Barthel Index score at hospital discharge, length of stay (LOS) in the ICU and hospital; Functional Status Score for the ICU at ICU discharge; and cumulative rate of patients reaching ICU Mobility Scale (IMS) levels ≥ 3, ≥4, and ≥ 7 within 28 days after ICU admission.

resultsAmong 552 eligible patients, 254 and 298 were admitted during the pre-EMRP and post-EMRP phases, respectively. In the propensity score-matched cohort, the post-EMRP group showed a higher proportion of home discharge (52.1% vs. 41.1%, difference: 11.0%, 95% confidence interval [CI]: 1.7-20.2%), higher Barthel Index score at hospital discharge (95.0 [55.0-100.0] vs. 80.0 [40.0-100.0], P = 0.007), and shorter LOS in the ICU (5.0 [3.0-11.0] vs. 7.0 [4.0-11.0] days, P = 0.03) than the pre-EMRP group. EMRP was associated with a higher rate of patients reaching IMS levels ≥ 3 (hazard ratio [HR]: 1.29, 95% CI: 1.06-1.57), ≥ 4 (HR: 1.27, 95% CI: 1.03-1.56), and ≥ 7 (HR: 1.36, 95% CI: 1.08-1.70).

conclusionsCompared with pre-EMRP implementation, EMRP for adult trauma patients was associated with a higher proportion of home discharge, an improved Barthel Index score at hospital discharge, and a shorter LOS in the ICU. These findings indicate that EMRP may facilitate returning home by improved physical function.

Indexed as

Early AmbulationWounds and InjuriesAdultAgedClinical ProtocolsFemaleHumansInjury Severity ScoreIntensive Care UnitsLength of StayMaleMiddle AgedOutcome Assessment, Health CarePropensity ScoreRetrospective StudiesTreatment OutcomeEarly mobilizationIntensive care unitRehabilitationStandardized protocolTrauma

Identifiers

PMID40739567
PMCPMC12312419

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.