Kyle Shaak, MPH
Biostatistician
Lehigh Valley Health Network, United States
Disclosure information not submitted.
Lauren Reightler, , OTD, OTR/L
Occupational Therapist
Lehigh Valley Hospital
Allentown, Pennsylvania
Disclosure information not submitted.
Title: Occupational Therapy Outcomes on Adults Mechanically Ventilated Secondary to COVID-19
Introduction: Occupational therapists rehabilitate individuals diagnosed with COVID-19 from the physical, cognitive, and psychosocial deficits resulting from their stay in the intensive care unit (ICU). The purpose of this study is to describe the outcomes of occupational therapy (OT) services received by individuals diagnosed with COVID-19 who required ventilator support.
Methods: A retrospective analysis of individuals diagnosed with COVID-19 requiring ventilator support was conducted on patients admitted to the five hospitals of Lehigh Valley Health Network from March 2020 through August 2020. Data was collected through chart review. Institutional Review Board approval was received prior to initiation of chart review.
Results: Of the 150 patients chart reviewed, 26% received OT services in the ICU. 12% of patients received an OT evaluation while on mechanical ventilation. The median number of days on mechanical ventilation for patients that received OT in the ICU (18.0) and those that did not (12.0) were statistically significant, U = 1,312.5, z = -3.654, p< .001. Of the patients that received OT in the ICU, 12.9% returned home following their hospitalization as opposed to 9.3% of all patients returned home following their hospitalization. There were no adverse safety outcomes reported during the OT sessions in the ICU. 20% of patients were assessed for delirium using the Confusion Assessment Method for the ICU (CAM-ICU); all patients identified were assessed by OT (76.9% of ICU patients with OT). Of the patients assessed, 63.5% scored CAM-ICU positive on initial OT evaluation.
Conclusions: OT services may be beneficial to identify delirium and promote ADL engagement and early mobilization in medically complex COVID-19 patients. In the ICU, occupational therapists are the primary evaluator of delirium using a standardized assessment. However, OT consults are more frequently received later in patients’ hospitalization. Earlier initiation of OT consults may lead to earlier identification of delirium in patients in the ICU diagnosed with COVID-19.