The respiratory rehabilitation Maugeri network service reconfiguration after 1 year of COVID-19

Submitted: March 12, 2021
Accepted: April 28, 2021
Published: June 8, 2021
Abstract Views: 2941
PDF: 1110
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

As part of the Italian Health Service the respiratory ICS Maugeri network were reconfigured and several in-hospital programs were suspended to be substituted by workforce and facilities reorganization for acute and post-acute COVID-19 care need. The present review shows the time course variation of respiratory ICS network in terms of admissions diagnosis and outcomes. A comparative review of the admissions and outcome measures data (anthropometric, admission diagnosis, provenience, comorbidities, disability, symptoms, effort tolerance, disease impact, length of stay and discharge destinations) over 1 year period (March 2020-March 2021) was undertaken and compared to retrospective data from a corresponding 1 year (March 2019-March 2020) period to determine the impact of the network relocation on the delivery of pulmonary specialist rehabilitation to patients with complex needs during the pandemic episode. One of the changes implemented at the respiratory Maugeri network was the relocation of the Pulmonary Rehabilitation units from its 351 beds base to a repurposed 247 beds and a reduction in total number of admitted patients (n=3912 in pre-COVID time; n=2089 in post COVID time). All respiratory diagnosis, except COVID sequelae, decreased (chronic respiratory failure-CRF, COPD, obstructive sleep apnoea syndrome-OSAS, interstitial lung disease-ILD, tracheostomized patients and other mixed diseases decreased of 734, 705, 157, 87, 79 and 326 units respectively). During the pandemic time, 265 post COVID sequelae with CRF were admitted for rehabilitation (12.62%), % of patients coming from acute hospital increased, LOS and NIV use remained stable while CPAP indication decreased. Disease impact, dyspnea and effort tolerance as their improvements after rehabilitation, were similar in the two periods.  Only baseline disability, expressed by Barthel index, seems higher in the 2° observation time as its improvement. Hospital deaths and transfers to acute hospitals were higher during pandemic crisis while home destination decreased. This review demonstrated impact of coronavirus pandemic situation, specifically the relocation of the respiratory inpatient rehabilitation wards in a huge Italian network.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Worldometer [Internet]. COVID-19 coronavirus pandemic. Accessed on: 10 April 2020. Available from: https://www.worldometers.info/coronavirus/
Global surveillance for human infection with coronavirus disease (COVID-2019). Accessed on: 10 April 2020. Available from: https://www.who.int/publicationsdetail/global-surveillance-for-human-infection-with-novelcoronavirus-(2019-ncov)
Istituto Superiore di Sanità. Accessed on: 10 April 2020. Available from: https://www.epicentro.iss.it/coronavirus5
Vitacca M, Migliori GB, Spanevello A, et al. Management and outcomes of post-acute COVID-19 patients in Northern Italy. Eur J Intern Med. 2020;78:159-60.
Simonelli C, Paneroni M, Fokom AG, et al. How the Covid-19 infection tsunami revolutionized the work of respiratory physiotherapists: An experience from northern Italy. Monaldi Arch Chest Dis 2020;90:1085. DOI: https://doi.org/10.4081/monaldi.2020.1085
Vitacca M, Migliori GB, Spanevello A, et al. Management and outcomes of post-acute COVID-19 patients in Northern Italy. Eur J Intern Med 2020;78:159-60. DOI: https://doi.org/10.1016/j.ejim.2020.06.005
Ceriana P, Nava S, Vitacca M, et al. Noninvasive ventilation during weaning from prolonged mechanical ventilation. Pulmonology 2019;25:328-33. DOI: https://doi.org/10.1016/j.pulmoe.2019.07.006
Maestri R, Bruschi C, Fracchia C, et al. Physiological and clinical characteristics of patients with COPD admitted to an inpatient pulmonary rehabilitation program: A real-life study. Pulmonology 2019;25:71-8. DOI: https://doi.org/10.1016/j.pulmoe.2018.07.001
Holland AE, Spruit MA, Troosters T, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J 2014;44:1428-46. DOI: https://doi.org/10.1183/09031936.00150314
Linn BS, Linn MW, Gurel L. Cumulative illness rating scale. J Am Geriatr Soc 1968;16:622-6. DOI: https://doi.org/10.1111/j.1532-5415.1968.tb02103.x
Mahoney FI, Barthel D. Functional evaluation: The Barthel Index. Md State Med J 1965;14:56-61. DOI: https://doi.org/10.1037/t02366-000
Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD Assessment Test. Eur Respir J 2009;34:648-54. DOI: https://doi.org/10.1183/09031936.00102509
Bernabeu-Mora R, Medina-Mirapeix F, Llamazares-Herrán E, et al. The Short Physical Performance Battery is a discriminative tool for identifying patients with COPD at risk of disability. Int J Chron Obstruct Pulmon Dis 2015;10:2619-26. DOI: https://doi.org/10.2147/COPD.S94377
Fletcher CM. Standardised questionnaire on respiratory symp-toms: a statement prepared and approved by the MRC Committee on the Aetiology of Chronic Bronchitis (MRC breath-lessness score). Br Med J 1960;2:1665.
Vitacca M, Paneroni M, Baiardi P, et al. Development of a Barthel Index based on dyspnoea for patients with respiratory diseases. Int J Chron Obstruct Pulmon Dis 2016;11:1199-206. DOI: https://doi.org/10.2147/COPD.S104376
Vitacca M, Carone M, Clini EM, et al. Joint statement on the role of respiratory rehabilitation in the COVID-19 crisis: The Italian position paper. Respiration 2020;99:493-9. DOI: https://doi.org/10.1159/000508399
Kamenov K, Mills JA, Chatterji S, Cieza A. Needs and unmet needs for rehabilitation services: a scoping review. Disabil Rehabil 2019;41:1227-37. DOI: https://doi.org/10.1080/09638288.2017.1422036
Cieza A, Causey K, Kamenov K, et al. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2021;396:2006-17. DOI: https://doi.org/10.1016/S0140-6736(20)32340-0
Kontopantelis E, Mamas MA, Deanfield J, et al. Excess mortality in England and Wales during the first wave of the COVID-19 pandemic. J Epidemiol Community Health 2021;75:213–23. DOI: https://doi.org/10.1101/2020.05.26.20113357
Negrini S, Grabljevec K, Boldrini P, et al. Up to 2.2 million people experiencing disability suffer collateral damage each day of COVID-19 lockdown in Europe. Eur J Phys Rehabil Med 2020;56:361-5. DOI: https://doi.org/10.23736/S1973-9087.20.06361-3
Marzolini S, Kin R, Lima de Melo Ghisi G, et al. Cardiac rehabilitation in Canada during COVID-19. CJC Open 2021;3:152-58. DOI: https://doi.org/10.1016/j.cjco.2020.09.021
Riley H, Stabile L, Wu WC. Transition to home-based treatment plans for center-based cardiac, pulmonary, and vascular rehabilitation during COVID-19. R I Med J (2013) 2020;103:30-3.
Vitacca M. Pulmonary rehabilitation in Italy today. Rassegna Patologia Apparato Respiratorio 2016;31:175-7.
Vitacca M, Scartabellati A, Banfi P, et al. Respiratory diseases in Lombardy: AIPO survey over two weeks of activity. Rassegna Patologia Apparato Respiratorio 2019;34:191-200.
Vitacca M, Crisafulli E, Balbi B, Carone M. Ruolo della riabilitazione respiratoria nell’emergenza coronavirus pneumologia riabilitativa e assistenza domiciliare. Rassegna Patologia Apparato Respiratorio 2020;3581-3.

How to Cite

Vitacca, Michele, Piero Ceriana, Bruno Balbi, Claudio Bruschi, Maria Aliani, Mauro Maniscalco, Francesco Fanfulla, Aldo Diasparra, Luigino Rizzello, Daniela Sereni, and Antonio Spanevello. 2021. “The Respiratory Rehabilitation Maugeri Network Service Reconfiguration After 1 Year of COVID-19”. Monaldi Archives for Chest Disease 91 (4). https://doi.org/10.4081/monaldi.2021.1843.