Early mobility in frail and non-frail older adults admitted to the cardiovascular intensive care unit

Publication date: October 2018
Source:Journal of Critical Care, Volume 47
Author(s): Michael Goldfarb, Jonathan Afilalo, Alice Chan, Romana Herscovici, Bojan Cercek
PurposeLittle is known about the effects of early mobilization in older adults in the Cardiovascular Intensive Care Unit (CICU).Materials and methodsWe reviewed consecutive patients ≥60 years of age admitted to the CICU at an academic tertiary care center from 2016 to 2017. The level of function (LOF) was assessed prehospital, at CICU admission, and at CICU transfer using a graded scale ranging from LOF 1 (bedbound) to 4 (walk > 50 ft). The prehospital frailty status was assessed using Rockwood’s Clinical Frailty Scale. We sought to determine whether the mean change of LOF during CICU admission differed based on frailty status.ResultsThere were 264 patients in the cohort (77.1 ± 9.3 years old; 40% female; 34% frail). Frail patients were more likely to have lower prehospital, CICU admission, day of transfer LOFs (all P < 0.001). The mean LOF improvement during CICU stay was 0.5 ± 0.8 and did not differ based on frailty status. Frailty was not predictive of EM responsiveness in the adjusted analysis.ConclusionsEM is feasible in older adults admitted to the CICU. Functional status improved in both frail and non-frail older adults during CICU admission. Prospective studies are needed to determine whether frail older adults may benefit from EM.