Early Mobilization in Older Adults with Acute Cardiovascular Disease
| Autor: | José A. Morais, Diana Dima, Michael Goldfarb, Koorosh Semsar-kazerooni |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Aging medicine.medical_specialty Hospitalized patients 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine Humans Medicine Hospital Mortality 030212 general & internal medicine Adverse effect Early Ambulation Aged Aged 80 and over Mobilization business.industry General Medicine Emergency department Length of Stay Intensive care unit Acute cardiovascular disease Intensive Care Units Cardiovascular Diseases Acute Disease Coronary care unit Early mobilization Female Geriatrics and Gerontology business |
| Zdroj: | Age and Ageing. 50:1166-1172 |
| ISSN: | 1468-2834 0002-0729 |
| DOI: | 10.1093/ageing/afaa253 |
| Popis: | Background Early mobilization (EM) is beneficial in critical care units and in older hospitalized patients, but little is known about EM in older adults with acute cardiovascular disease. Methods Consecutive admissions of adults ≥80 years old to a Cardiac Intensive Care Unit (CICU) prior to and following implementation of a nurse-driven EM program were reviewed. Mobility was measured using the Level of Function (LOF) Mobility Scale, which ranges from 0 (bed immobile) to 5 (able to walk >20 meters). The primary outcome was discharge home. Results There were 412 patients included (N = 234, intervention; N = 178, preintervention). There was no difference in age between groups (overall 86.3 ± 4.8 years old) or sex (overall female N = 215, 52.2%). In the intervention group, functional impairment was present in 89 patients (38.0%) prehospitalization and in 209 patients (89.3%) on admission. Nearly half of patients (N = 107; 45.7%) improved their LOF by ≥1 during admission. Mobilization occurred during nearly all opportunities (838/850; 98.6%), and most mobility activities were completed (2,207/2,553; 86.4%). Adverse events were rare (5/2,207 activities [0.2% adverse event rate]) and transient. Patients in the intervention group were more likely than patients in the preintervention group to be discharged home (74.4 vs. 65.7%, P = 0.047, respectively) and had a lower rate of in-hospital death (6.4 vs. 14.6%, P = 0.006, respectively). There was no difference in mean length of hospital stay, 30-day emergency department visit or hospital re-admission. Conclusion EM is safe in older adults in the CICU and is associated with reduced discharge to healthcare facility and in-hospital mortality. |
| Databáze: | OpenAIRE |
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