Early mobilization in the postoperative patients submitted to cardiac surgery – A systematic review

Abstract

Background: Cardiovascular diseases are currently the main cause of mortality and hospitalization in the adult population and cardiac surgery is an option of treatment. Postoperative complications are still frequent and can determines the length of hospital staying. Early mobilization can be used in these patients to reduce such complications and the evidences for such intervention remains unknown. Objective: Systematically review the effects of early mobilization on length of hospital stay and on postoperative complications in patients undergoing elective cardiac surgery. Methods: Randomized controlled trials using early mobilization in patients after cardiac surgery were searched and selected on the following databases: Medline, Embase, CINAHL, PEDro, Web of Science and Cochrane Central Register of Controlled Trials. Early mobilization was defined as any form of exercise within 72 hours after surgery. Results: 2514 studies were identified and 18 articles were full read for eligibility analysis. Nine studies were included and they present low risk of bias by PEDro score (range 5 to 9). The length of hospital staying ranged from 5.9 to 12.2 days. Only three studies observed that the early mobilization group reduced the length of hospital stay when compared to the control group. Five studies evaluated postoperative complications and only one showed lower incidence of complications with early mobilization. Conclusion: The results of this systematic review show that there is still low quality evidence suggesting that early mobilization can reduce the incidence of postoperative complications and the length of hospital stay in patients submitted to cardiac surgery.