Izazovi u ranoj rehabilitaciji hirurških bolesnika sa COVID-19 infekcijom – single-arm studija

  • Dušica Simić-Panić *University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, †Medical Rehabilitation Clinic, Novi Sad, Serbia
  • Ksenija Bošković *University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; ‡Special Hospital for Rheumatic Diseases, Novi Sad, Serbia
  • Slobodan Pantelinac *University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; †Medical Rehabilitation Clinic, Novi Sad, Serbia
  • Aleksandar Knežević *University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, †Medical Rehabilitation Clinic, Novi Sad, Serbia
  • Predrag Jovićević Special Hospital for Rheumatic Diseases, Novi Sad, Serbia
  • Apostolos Kozios University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Nataša Janjić *University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Department of Orthopedic Surgery and Traumatology, Novi Sad, Serbia
  • Nikola Nikolić University Clinical Center of Vojvodina, Department of Abdominal and Endocrine Surgery, Novi Sad, Serbia
  • Larisa Vojnović *University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, †Medical Rehabilitation Clinic, Novi Sad, Serbia
  • Snežana Tomašević-Todorović *University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, †Medical Rehabilitation Clinic, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP231228033S
Ključne reči: covid-19;, hirurgija, opšta;, rehabilitacija;, lečenje, ishod.

Sažetak


Uvod/Cilj. U aktuelnoj literaturi dostupno je veoma malo podataka o ishodu rehabilitacije hirurških bolesnika obolelih od COVID-19. Cilj istraživanja bio je da ukaže na karakteristike rane rehabilitacije ovih bolesnika i da se utvrde prediktori ishoda rehabilitacije. Metode. Studija je bila osmišljena kao prospektivno kliničko ispitivanje i obuhvatila je bolesnike koji su bili hirurški lečeni od 1. aprila 2022. do 31. marta 2023. godine u Univerzitetskom kliničkom centru Vojvodine, Srbija, a koji su bili  pozitivni na severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperativno ili su razvili koronavirusnu bolest 2019 (COVID-19) u roku od 72 sata nakon operativnog tretmana. Program rehabilitacije planiran je za svakog bolesnika pojedinačno, shodno vrsti hirurškog lečenja, uzrastu, kliničkoj slici i težini COVID-19, dužini imobilizacije i komorbiditetima. Tretman rehabilitacije (TR) je počinjao sa najmanje jednom sesijom od 30 minuta dnevno, do tri dnevne sesije od po 30 minuta. Bolesnici su procenjivani na početku TR i pri otpustu iz bolnice. Za procenu ishoda korišćene su modifikovana Borgova skala


(MBS) za dispneju, Bartelov indeks (BI) za aktivnosti svakodnevnog života, Šestominutni test hoda (Six-Minute Walk Test-6MWT) za toleranciju vežbanja i test Ustani i kreni (Timed up and Go-TUG), za ravnotežu i pokretljivost donjih ekstremiteta. Rezultati. U studiju je bilo uključeno ukupno 81 bolesnika. TR je bio uspešan kod 42 bolesnika (24 žene i 18 muškaraca) prosečne starosti 62,10 ± 20,07 godina. Ovi bolesnici su pokazali značajno funkcionalno poboljšanje koje je izmereno svim testovima za procenu ishoda rehabilitacije, pri otpustu: BI (p < 0,001), MBS (p < 0,001), 6MWT (p < 0,001) i test TUG (p < 0,001). Preostalih 31 bolesnika nije imalo uspešan TR. Binarna logistička regresiona analiza pokazala je da su starost (p = 0,009), kardiovaskularne bolesti (p = 0,017) i mali-gnitet (p = 0,022) značajni prediktori ishoda rehabilitacije. Zaključak. Rezultati ove studije ukazuju da je individualno prilagođen TR tokom akutne faze COVID-19 kod hirurških bolesnika veoma izazovan. Starije životno doba, kardiovaskularne bolesti i malignitet su prediktori nepovoljnog ishoda i potrebno je pažljivo razmatranje prilikom planiranja lečenja ovih bolesnika.

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Objavljeno
2024/06/27
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Vol. 81 Br. 06 (2024): Vojnosanitetski pregled
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Originalni članak