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Functional Mobility Trajectories Across ICU Settings: A Comparative Cohort Study of Neuro-Trauma, Surgical and
Eder Chaves Pacheco1, Fernando Nataniel Vieira2, Christiane Perme3
1Universidade do Vale dos Sinos (UNISINOS), São Leopoldo, Rio Grande do Sul, Brazil.
Background:
Immobility results in ICU-acquired muscle weakness, leading to increased mechanical ventilation time and mortality. However, the type of ICU in which the patient is admitted must be considered.
Aim:
To evaluate the mobility status of patients across three different ICUs to better understand mobility levels during critical illness in ICUs specialized in different patient populations.
Study Design:
This was a prospective observational cohort study conducted in three ICUs with distinct patient populations: neuro ICU, surgical ICU and medical ICU. Mobility status was assessed daily using the Perme ICU Mobility Score (Perme Score) until discharge or Day 28 in the ICU.
Results:
The study included 63 patients in the neuro ICU, 66 patients in the surgical ICU and 43 patients in the medical ICU. A significant difference was observed in the mean Perme Score among the three ICUs. The neuro-trauma ICU presented on average a lower Perme Score during the 28 days. Different from the other ICUs, the highest improvement of mobility status for patients in the Neuro population happened on the 28th day. In the Medical ICU, mobility status peaked on the 7th day and reached its lowest score on the 11th day. The Surgical ICU presented on average the highest Perme Score on ICU admission. When the three ICUs were compared, an effect on functional status occurred, with the third day being the highest for the mobility status in all units (p = 0.16).
Conclusions:
This study demonstrated that patients exhibit varying levels of mobility upon admission to different ICUs, which are associated with severity of illness and outcomes.
Relevance To Clinical Practice:
Understanding the different impacts of mobility on hospitalized patients will facilitate the rehabilitation process by the multidisciplinary team.
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