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Background <p>Early mobilization is widely adopted in modern ICU practice, but evidence regarding the safety and clinical outcomes of early ceiling lift-assisted out-of-bed sitting training (OBST) remains limited.</p> Methods <p>This prospective observational cohort study was conducted in the ICU of Zhongda Hospital, Nanjing, China. Adults aged 18–80&#xa0;years who underwent ceiling lift–assisted OBST and had an ICU stay of ≥ 24&#xa0;h, were categorized by the timing of their first OBST session as early (≤ 72&#xa0;h after ICU admission) or late (&gt; 72&#xa0;h after ICU admission). Trained personnel prospectively collected data from electronic health records, session logs, and telephone interviews as appropriate. Propensity score matching was used to adjust for potential confounders. The primary outcome was the rate of potential safety events per OBST session; non-inferiority of early OBST was prespecified with a 2% absolute margin.</p> Results <p>Between February 1, 2023, and May 17, 2024, 584 patients were screened, and 396 were enrolled (early: n = 136; late: n = 260). After 1:1 propensity score matching, 125 patients remained in each matched group. Potential safety event rates were 0.36% (early) vs 0.99% (late) per session (risk difference: − 0.63%; 95% CI: − 1.51% to 0.25%). The upper limit of the 95% CI was below the 2% noninferiority margin. Early OBST was associated with greater improvement in FSS-ICU scores (mean difference: 1.31 points, <i>P</i> = 0.020), shorter ICU length of stay (mean difference: − 2.75&#xa0;days, <i>P</i> &lt; 0.001), and fewer OBST sessions (mean difference: − 2.02 sessions, <i>P</i> &lt; 0.001). Follow-up for 28-day post-ICU mortality was completed in 96.4% of patients.</p> Conclusions <p>Early ceiling lift–assisted OBST was associated not with increased safety event rates but with improved functional outcomes and a shorter ICU stay. These findings suggest that early OBST can be used safely in ICU mobilization and warrant evaluation in randomized controlled trials.</p> Trial registration <p>Chinese Clinical Trial Registry (ChiCTR), ChiCTR2200066701. Registered on 14 December 2022.</p>

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Timing of ceiling lift–assisted out-of-bed sitting training and outcomes in critically ill patients: a prospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月17日

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  • Zhengyong Hu,
  • Yuwen Chen,
  • Liang Xu,
  • Lanqi Guo,
  • Yong Li,
  • Min Mo,
  • Jingyuan Xu,
  • Xiaoqing Li,
  • Yufen Zhu,
  • Xiang Hong,
  • Hongxing Wang,
  • Songqiao Liu

摘要

Background

Early mobilization is widely adopted in modern ICU practice, but evidence regarding the safety and clinical outcomes of early ceiling lift-assisted out-of-bed sitting training (OBST) remains limited.

Methods

This prospective observational cohort study was conducted in the ICU of Zhongda Hospital, Nanjing, China. Adults aged 18–80 years who underwent ceiling lift–assisted OBST and had an ICU stay of ≥ 24 h, were categorized by the timing of their first OBST session as early (≤ 72 h after ICU admission) or late (> 72 h after ICU admission). Trained personnel prospectively collected data from electronic health records, session logs, and telephone interviews as appropriate. Propensity score matching was used to adjust for potential confounders. The primary outcome was the rate of potential safety events per OBST session; non-inferiority of early OBST was prespecified with a 2% absolute margin.

Results

Between February 1, 2023, and May 17, 2024, 584 patients were screened, and 396 were enrolled (early: n = 136; late: n = 260). After 1:1 propensity score matching, 125 patients remained in each matched group. Potential safety event rates were 0.36% (early) vs 0.99% (late) per session (risk difference: − 0.63%; 95% CI: − 1.51% to 0.25%). The upper limit of the 95% CI was below the 2% noninferiority margin. Early OBST was associated with greater improvement in FSS-ICU scores (mean difference: 1.31 points, P = 0.020), shorter ICU length of stay (mean difference: − 2.75 days, P < 0.001), and fewer OBST sessions (mean difference: − 2.02 sessions, P < 0.001). Follow-up for 28-day post-ICU mortality was completed in 96.4% of patients.

Conclusions

Early ceiling lift–assisted OBST was associated not with increased safety event rates but with improved functional outcomes and a shorter ICU stay. These findings suggest that early OBST can be used safely in ICU mobilization and warrant evaluation in randomized controlled trials.

Trial registration

Chinese Clinical Trial Registry (ChiCTR), ChiCTR2200066701. Registered on 14 December 2022.