Abstract
Background: Progressive mobility in the ICU has been recommended; however, the definitions of low, moderate, and high mobility in the ICU still diverge between studies. Therefore, our objective was to classify the mobility of the sample from verticalization and active withdrawal from the bed, and from that, to analyze the chances of discharge, death, and readmission to the ICU. Materials and methods: This is an observational and retrospective study that consults the medical records of individuals admitted to the ICU of the University Hospital of Sergipe (HU/SE) between August 2017 and August 2018. Mobility level was classified based on the Intensive Care Unit Mobility Scale (IMS). Results: A total of 121 individuals were included. The mean age was 61.45 ± 16.45, being 53.7% female. Of these, 28 (23.1%) had low mobility, 33 (27.3%) had moderate mobility, and 60 (49.6%) had high mobility. Individuals with low mobility were 45 times more likely to die (OR = 45.3; 95% CI = 3.23–636.3) and 88 times less likely to be discharged from the ICU (OR = 0.22; 95% CI = 0.002–0.30). Conclusion: Those who evolved with low mobility had a higher chance of death and a lower chance of discharge from the ICU. Moderate and high mobility were not associated with the investigated outcomes.
Highlights
The assessment of mobility of individuals hospitalized in intensive care units (ICUs) has been recommended to quantify the responses to therapies, evolution, or functional decline of individuals [1]
The main findings of the present study were that individuals with low mobility were 88 times less likely to be discharged from the ICU and 45 times more likely to evolve to death in the ICU
Early mobilization protocols are implemented as part of the routine of these units as a strategy to increase the mobility of individuals, which starts with passive movement in bed in bed, but it requires progression to antigravity postures, with systematically increased levels of mobilization, which culminate in the removal of the patient from the bed [1,17,18]
Summary
The assessment of mobility of individuals hospitalized in intensive care units (ICUs) has been recommended to quantify the responses to therapies, evolution, or functional decline of individuals [1]. Even in an institution where there are early mobilization protocols and in the face of recommendations for the insertion of mobilization protocols at systematic levels of progression of postures and activities, studies have shown that the highest level of mobilization achieved by most individuals, prior to discharge from the ICU, has been turning over in bed, corresponding to 57.5% of the sample [1,3,4]. It has been suggested that the multidisciplinary team work with progressive mobility goals, culminating in out-of-bed mobilization, so that in addition to reducing the length of stay in the ICU, they favor greater mobility, aiming to improve individual-centered outcomes such as improved function and quality of life post discharge [4,5,8]. Moderate and high mobility were not associated with the investigated outcomes
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