Article

The surgical intensive care unit optimal mobility score predicts mortality and length of stay.

Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Critical care medicine (impact factor: 6.37). 11/2011; 40(4):1122-8. DOI:10.1097/CCM.0b013e3182376e6d pp.1122-8
Source: PubMed

ABSTRACT To test if the surgical intensive care unit optimal mobility score predicts mortality and intensive care unit and hospital length of stay.
Prospective single-center cohort study.
Surgical intensive care unit of the Massachusetts General Hospital.
One hundred thirteen consecutive patients admitted to the surgical intensive care unit.
We tested the hypotheses that the surgical intensive care unit optimal mobility score independent of comorbidity index, Acute Physiology and Chronic Health Evaluation II, creatinine, hypotension, hypernatremia, acidosis, hypoxia, and hypercarbia predicts hospital mortality, surgical intensive care unit and total hospital length of stay.
Two nurses independently predicted the patients' mobilization capacity by using the surgical intensive care unit optimal mobility score the morning after admission, whereas a third nurse recorded the achieved mobilization levels of patients at the end of the day. A multidisciplinary expert team measured patients' grip strength and assessed their predicted mobilization capacity independently. Multivariate analysis revealed that the surgical intensive care unit optimal mobility score was the only independent predictor of mortality. Surgical intensive care unit optimal mobility score, hypotension, and hypernatremia (>144 mmol/L) independently predicted intensive care unit length of stay, whereas the surgical intensive care unit optimal mobility score and hypernatremia predicted total hospital length of stay. The Acute Physiology and Chronic Health Evaluation II score was not identified in the multivariate analysis. The surgical intensive care unit optimal mobility score was also a reliable and valid instrument in predicting achieved mobilization levels of patients.
In surgical critically ill patients presenting without preexisting impairment of functional mobility, the surgical intensive care unit optimal mobility score is a reliable and valid tool to predict mortality and intensive care unit and hospital length of stay.

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Keywords

achieved mobilization levels
 
Chronic Health Evaluation II
 
Chronic Health Evaluation II score
 
comorbidity index
 
hospital mortality
 
intensive care unit
 
intensive care unit length
 
Massachusetts General Hospital
 
mobilization levels
 
multidisciplinary expert team
 
multivariate analysis
 
patients' grip strength
 
patients' mobilization capacity
 
predicted mobilization capacity
 
Prospective single-center cohort study
 
surgical
 
surgical intensive care unit
 
surgical intensive care unit optimal mobility score
 
total hospital length
 
valid tool
 

George Kasotakis