Should impaired mobility on presentation be a vital sign?

Area of Science:

• Clinical Medicine
• Geriatrics
• Critical Care Medicine

Background:

• Traditional vital signs are essential for assessing acutely ill patients but may not identify all individuals at risk of mortality.
• Impaired mobility on presentation (IMOP) has emerged as a potential indicator of patient risk.

Purpose of the Study:

• To compare the predictive power of impaired mobility on presentation (IMOP) against traditional vital signs, age, and comorbidities for patient mortality.
• To evaluate IMOP as a standalone predictor of mortality in diverse patient cohorts.

Main Methods:

• A retrospective multicenter cohort study involving 9684 Danish and Irish patients and 1010 Ugandan patients.
• Patients were stratified based on IMOP, National Early Warning Score (NEWS), Charlson Comorbidity Index, and age.
• Statistical analyses included univariate and multivariate logistic regression to assess mortality prediction.

Main Results:

• Fourteen percent of Danish/Irish patients and 42% of Ugandan patients presented with IMOP.
• IMOP demonstrated significant odds ratios for 7-day mortality in both cohorts, comparable to or exceeding other risk factors.
• Multivariate analysis confirmed IMOP as an independent predictor of 7-day and 30-day mortality, outperforming traditional vital signs and comorbidities.

Conclusions:

• Immobility on presentation is a crucial vital sign for acutely ill patients.
• IMOP independently predicts mortality, offering valuable prognostic information beyond conventional assessments.
• Integrating IMOP assessment can enhance the identification of high-risk patients.