床上骑自行车和常规物理治疗对接受机械通风的患者的成本效益
Jean-Eric Tarride1,2, Gord Blackhouse1,2, Bram Rochwerg1,3
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
JAMA network open
|September 8, 2025
概括
在ICU中为机械通风的成年人添加早期的床上循环治疗通常的物理治疗并没有显著影响成本或质量调整后生命年 (QALYs). 需要对重症患者进行进一步的成本效益研究.
科学领域:
- 关键护理医学 关键护理医学
- 卫生经济学 卫生经济学
- 康复 康复 康复 康复
背景情况:
- 对于机械通风ICU患者的早期床上循环的成本效益尚不清楚.
- 通常的物理治疗是标准的护理,但其最佳的辅助需要评估.
研究的目的:
- 评估早期床上骑自行车加上通常的物理治疗与单独的通常物理治疗的成本效益.
- 这项分析与临床临床试验"关键护理循环改善下肢力量 (CYCLE) "一起进行.
主要方法:
- 从社会角度对90天的时间进行基于试验的经济评估.
- 在成人ICU患者中,早期的床上循环 (在通风4天内) 与通常的物理治疗进行了比较.
- 计算成本 (2024加元) 和经质量调整的寿命年 (QALYs) 的差异.
主要成果:
- 招募360名患者;平均年龄为61.5岁,56.9%是男性.
- 早期在床上骑自行车的费用是最小的 (0.5%的住院费用).
- 在90天成本 (CA$5841) 或QALYs (-0.0009) 中没有观察到群体之间的统计学上显著差异.
结论:
- 在常规物理治疗中添加早期的床上循环治疗并没有显著改变机械通风ICU患者的成本或QALY.
- 结果表明,进一步的成本效益研究是有必要的,考虑到更广泛的证据基础在重症监护的床上骑自行车.
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