Abstract 18297: Association Of Maximum Daily Mobility After Open Cardiac Surgery And Clinical Outcomes

Abstract

Introduction: Hospital-based mobility after coronary artery bypass graft (CABG) and valve surgery using a mid-sternal incision is valuable and facilitated by use of Phase 1 cardiac rehabilitation. However, rehabilitation services may be limited and patients may not receive the full benefits of early mobility. Further, factors associated with maximum daily mobility and clinical outcomes need to be better understood. Research Questions: What is the degree of maximum daily mobility variability during hospitalization and what factors are associated with higher maximum daily mobility? Methods: This prospective, correlational design used a daily mobility form, surveys and medical records data from 5 hospitals in 5 states. Nurses collected mobility (daily) and psychological status (one time, post intensive care unit [ICU] stay) using valid and reliable tools. Medical record data were retrieved by analysts. Maximum daily mobility scores were categorized into 4 groups; higher levels represented greater mobility. Relationships between mobility category scores and patient factors were described using Spearman correlations (95% confidence intervals. Results: Of 650 participants with a median [25th, 75th percentile] of 4.0 [3.0, 5.0] days of post-ICU daily mobility data, lowest to highest category rates were 9.5% (n=62), 9.8% (n=63), 16.2% (n=105) and 64.5% (n=419). Higher maximum daily mobility was associated with hospital site, younger age, male gender, commercial insurance, lower body mass index, no history of prior myocardial infarction, heart failure, aortic or pulmonic valve disease, cerebrovascular disease or diabetes, higher hemoglobin/hematocrit, lower serum creatinine and lower rates of prolonged ventilation (all p &lt0.05). Higher maximum daily mobility was associated with higher general health perception scores (rho 0.12 (0.04, 0.19), p=0.003, shorter hospital length of stay and an increased likelihood of discharge to home (both p &lt0.01). Conclusions: After CABG/valve surgery, maximal daily mobility varied by multiple factors, many of which were not directly associated with patient’s ability to ambulate. Attention to achieving higher post-ICU daily mobility levels are warranted.