Photo Credit: gorodenkoff
The following is a summary of “Patient, practice, and organizational factors associated with early mobility performance in critically ill adults,” published in the September 2024 issue of Critical Care by Krupp et al.
Adopting early mobility interventions in intensive care unit (ICU) practice has been slow and varied.
Researchers conducted a retrospective study to investigate factors linked to critically ill adults with early mobility performance and to assess the effects of factors on predicting next-day early mobility performance.
They investigated 66 patients’ ICU data admitted for at least 24 hours. Mixed-effects logistic regression modeling was performed, and the area under the receiver operating characteristic curve (AUC) was calculated.
The results showed that in 12,489 patients, factors alone linked with higher odds of next-day mobility included significant pain (adjusted odds ratio (AOR), 1.16; 95% CI, 1.09-1.23), documented sedation target (AOR, 1.09; 95% CI, 1.01-1.18), performance of spontaneous awakening trials (AOR, 1.77; 95% CI, 1.59-1.96), spontaneous breathing trials (AOR, 2.35; 95% CI, 2.14-2.58), mobility safety screening (AOR, 2.26; 95% CI, 2.04-2.49), and prior-day physical/occupational therapy (AOR, 1.44; 95% CI, 1.30-1.59). Factors were independently associated with lower odds of next-day mobility with deep sedation (AOR, 0.44; 95% CI, 0.39-0.49), delirium (AOR, 0.63; 95% CI, 0.59-0.69), benzodiazepine administration (AOR, 0.85; 95% CI, 0.79-0.92), physical restraints (AOR, 0.74; 95% CI, 0.68-0.80), and mechanical ventilation (AOR, 0.73; 95% CI, 0.68-0.78) whereas black and Hispanic patients had lower odds of next-day mobility than other patients. Patients incorporating models, practice, and between-unit variations displayed high discriminant accuracy (AUC,0.853) in predicting next-day early mobility performance.
They concluded that several modifiable and nonmodifiable factors present excellent predictions of next-day early mobility performance.
