Limited Mobility to the Bed Reduces the Chances of Discharge and Increases the Chances of Death in the ICU

Talita Leite Dos Santos Moraes; Joana Monteiro Fraga de Farias; Brunielly Santana Rezende; Fernanda Oliveira de Carvalho; Michael Silveira Santiago; Erick Sobral Porto; Felipe Meireles Doria; Kleberton César Siqueira Santana; Marcel Vieira Gomes; Victor Siqueira Leite; Reuthemann Esequias Teixeira Tenório Albuquerque Madruga; Leonardo Yung Dos Santos Maciel; Juliana Dantas Andrade; Jader Pereira de Farias Neto; Felipe J Aidar; Walderi Monteiro da Silva Junior

doi:10.3390/clinpract12010002

Limited Mobility to the Bed Reduces the Chances of Discharge and Increases the Chances of Death in the ICU

Clin Pract. 2021 Dec 21;12(1):8-16. doi: 10.3390/clinpract12010002.

Authors

Talita Leite Dos Santos Moraes¹, Joana Monteiro Fraga de Farias¹, Brunielly Santana Rezende¹, Fernanda Oliveira de Carvalho², Michael Silveira Santiago¹, Erick Sobral Porto³, Felipe Meireles Doria⁴, Kleberton César Siqueira Santana⁵, Marcel Vieira Gomes⁶, Victor Siqueira Leite⁶, Reuthemann Esequias Teixeira Tenório Albuquerque Madruga⁷, Leonardo Yung Dos Santos Maciel⁸, Juliana Dantas Andrade², Jader Pereira de Farias Neto⁹, Felipe J Aidar¹, Walderi Monteiro da Silva Junior^{1

2

9}

Affiliations

¹ Graduate Program in Physical Education, Federal University of Sergipe (PPGEF-UFS), São Cristovão 49100-000, SE, Brazil.
² University Hospital, Federal University of Sergipe (HU/UFS), Aracaju 49060-108, SE, Brazil.
³ Department of Medicine, Tiradentes University (UNIT), Aracaju 49032-490, SE, Brazil.
⁴ Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, SE, Brazil.
⁵ Military Police Hospital, Aracaju 49072470, SE, Brazil.
⁶ Program of Traumatology and Orthopaedics, Federal University of Sergipe (UFS), São Cristovão 49100-000, SE, Brazil.
⁷ Department of Medicine, Federal University of Sergipe (UFS), São Cristovão 49100-000, SE, Brazil.
⁸ Department of Physiotherapy of Lagarto, Federal University of Sergipe (UFS), Lagarto 49400-000, SE, Brazil.
⁹ Department of Physiotherapy, Federal University of Sergipe (UFS), São Cristovão 49100-000, SE, Brazil.

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.

Keywords: early ambulation; intensive care unit; mobility limitation.