The following is a summary of “Early Mobility Index and Patient Outcomes: A Retrospective Study in Multiple Intensive Care Units,” published in the May 2024 issue of Critical Care by Fazio et al.
Early ICU mobility is safe and beneficial, but implementation and optimal mobility dose remain unclear.
Researchers started a retrospective study investigating the relationship between daily out-of-bed mobility and patient outcomes across various ICUs.
They examined electronic records from 7 adult ICUs at an academic quaternary hospital. Multivariable linear regression examined the effects of out-of-bed events per mobility-eligible day on the duration of mechanical ventilation and the length of ICU and hospital stays.
The result showed 8,609 adults hospitalized in ICUs (2015 to 2018). On 46.5% of ICU days, patients were mobilized out of bed, and on 2.7 (2–9) ICU days, a median (IQR) of 2.0 (1-3) patients were eligible for mobility treatments. Per mobility-eligible day, the median (IQR) out-of-bed occurrences was 0.5 (0–1.2). The length of mechanical ventilation decreased by 10% for every unit increase in out-of-bed occurrences per mobility-eligible day before extubation (adjusted coefficient [95%CI], −0.10 [−0.18 to −0.01]). Daily mobility increased ICU stays by 4% (adjusted coefficient [95%CI], 0.04 [0.03–0.06]) and decreased hospital stays by 5% (adjusted coefficient [95%CI], −0.05 [−0.07 to −0.03]). Among ICUs, effect sizes were varied.
Investigators concluded that increased daily out-of-bed mobility in ICU controls correlated with shorter ventilation times and hospital stays, suggesting a dose-dependent effect. However, the relationships varied across ICU sub-groups.
Source: aacnjournals.org/ajcconline/article/33/3/171/32431/Early-Mobility-Index-and-Patient-Outcomes-A