Get out of bed!

Pneumonia patients can leave hospital sooner

Many advances in medical treatment involve complicated new technologies or procedures.

But infectious disease expert Linda Mundy, M.D., associate professor of medicine, recently reported promising results with a new, simple pneumonia treatment: Get patients out of bed earlier and more often, and they’ll check out of the hospital an average of one day sooner.

Linda Mundy
Linda Mundy

“The treatment really was that simple,” said Mundy, who noted that the study still needs to be repeated on a larger scale to verify its results. “There are so many pneumonia hospitalizations in the United States. If it really does work and patients go home earlier, from a societal standpoint, the cost-savings would be tremendous.”

In a study published recently in the journal Chest, Mundy and her colleagues at Barnes-Jewish Hospital, Christian Hospital Northeast and Missouri Baptist Medical Center worked with patients who became infected with pneumonia outside the hospital environment.

Patients who received the experimental treatment, known as early mobilization, were required to get out of their beds and either sit upright or walk for 20 minutes during the first 24 hours of hospitalization, with progressively longer times spent upright on succeeding days.

Mundy was inspired to try this treatment after reading studies that showed similar results in postoperative and post-heart attack patients.

Doctors rate pneumonia with a severity index, ranging from one to five. Beneficial effects of the early mobilization were most pronounced in patients with a severity index of three.

Researchers also found the early mobilization treatment did not increase the risk of injury through falls, heart attacks or other incidents.

“We still don’t know why this therapy helps,” Mundy said. “Being upright may have made patients feel they were getting better, allowed better distribution of the antibiotics to the part of their lung that’s collapsed or led physicians to perceive patients were doing better and therefore send them home.”

With the help of University physicians and doctors and nurses at the two regional hospitals, Mundy and her co-authors were able to study the new technique in 458 patients. The study was partially funded by BJC Health Systems Innovations for Healthcare Programs.

“We wanted to do the study at a regional level to show that it could be generalized beyond the academic medical setting,” Mundy said, “and it was nice to see the academic medical center and the two community hospitals really work well together.”

Mundy said several aspects of the findings need to be researched further, including checking if the results can be duplicated in other patient populations, evaluating the effects of early mobilization on long-term patient mortality and probing how early mobilization interacts with other pneumonia treatments.

“If it is helpful, let’s start helping people go home sooner and benefit from it,” she said. “It’s so simple — sometimes less is more.”

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