Mobilizing pneumonia patients helps them go home earlier

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

But infectious disease expert Linda Mundy, M.D., associate professor of medicine, says one of the most effective new treatments for pneumonia is very simple: Get patients out of bed earlier and more often, and they’ll check out of the hospital an average of one day sooner.

“The treatment really was that simple,” Mundy says, but she notes 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.”

Chest x-ray of a lung affected by pneumonia
Chest x-ray of a lung affected by pneumonia

She reported her findings in a study published recently in the journal Chest. Mundy and 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 their first 24 hours of hospitalization, with progressively longer times spent upright on succeeding days.

Mundy was inspired to take this treatment approach 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.

Linda Mundy
Linda Mundy

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

“We still don’t know why this therapy helps,” Mundy says. “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 Washington 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 says, “and it was nice to see the academic medical center and the two community hospitals really work well together.”

Mundy says several aspects of the findings need to be researched further, including checking to see if the results can be replicated in other patient populations, evaluating the effects of early mobilization on long-term patient mortality and leaerning 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 says. “It’s so simple — sometimes less is more.”