title: Potential effect of physiotherapeutic treatment on mortality rate in patients with severe sepsis and septic shock: a retrospective cohort analysis.
abstract: OBJECTIVE
  The aim of the study was to examine the onset and frequency of physiotherapeutic interventions (PTI) and their potential effects on the intensive care unit (ICU) mortality rate in patients with severe sepsis or septic shock.
  
  
  METHODS
  Retrospective data analysis. Univariate and multivariate Cox proportional-hazards regression analyses were performed.
  
  
  RESULTS
  About 6.2% of all patients (n = 999, length of ICU stay 12 days, averaged SOFA score 14) developed sepsis within three years. Of these, 77% received at least once PTI. The relative number of PTI (RNPTI index, individually calculated by the number of PTI/length of stay) in patients with sepsis was 42%. The first physiotherapeutic treatment was five days after ICU admission. Cox regression multivariate analysis adjusted by disease severity scores, sedation state and other clinical variables found RNPTI index as significant risk factor for the ICU mortality rate (hazard ratio, 0.982; 95% confidence interval, 0.974-0.990; P < .001).
  
  
  CONCLUSIONS
  Physiotherapists routinely assess and treat patients with sepsis. The frequency of PTI was associated with an improved outcome. Prospective studies are necessary to confirm the potential favorable impact.
authors: Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany; Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany. Electronic address: maik.soscxsdorf@med.uni-jena.de.
authors: Maik
authors: M
authors: Sossdorf
authors: Gordon P
authors: GP
authors: Otto
authors: Katja
authors: K
authors: Menge
authors: Ralf A
authors: RA
authors: Claus
authors: Wolfgang
authors: W
authors: Lösche
authors: Björn
authors: B
authors: Kabisch
authors: Matthias
authors: M
authors: Kohl
authors: Ulrich C
authors: UC
authors: Smolenski
authors: Peter
authors: P
authors: Schlattmann
authors: Konrad
authors: K
authors: Reinhart
authors: Johannes
authors: J
authors: Winning
mesh_terms: D018806:APACHE; D000368:Aged; D003422:Critical Care / Q000379:methods; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality* / Q000534:rehabilitation*; D012772:Shock, Septic / Q000401:mortality / Q000534:rehabilitation; D016896:Treatment Outcome
keywords: Critically ill; Mortality; Outcome; Physical therapy; Physiotherapy; Sepsis