ICU Mobility Scale as a predictor of hospital mortality in critically ill patients

<bold>Objective:</bold> To assess whether the ICU mobility scale (IMS) is capable of predicting hospital mortality after ICU discharge. <bold>Methods:</bold> Observational, prospective, single-center study that evaluated 1,512 critically ill patients. All patients with >48 hours of ICU stay were included. The exclusion criteria were as follows: patients unable to walk independently before hospitalization, neurologically impaired, with a terminal/end-of-life status, or had data loss. The IMS is an 11-point ordinal scale with scores ranging from 0 (absence of mobilization) to 10 (independent ambulation). Patients were categorized into low (IMS=0 to 2), moderate (IMS=3 to 5) and high mobility (IMS=6-10). The mobility scale was quantified: 30 days before admission, admission and discharge from the ICU. Admission diagnosis, SAPS3, SOFA in the first 24 hours, comorbidities, laboratory tests, invasive and non-invasive mechanical ventilation were evaluated. <bold>Results:</bold> A total of 239 (15%) patients lost mobility until discharge from the ICU when compared to 30 days before admission. Patients who lost mobility during the ICU were older, had worse SAPS-3 and SOFA scores, and had a greater number of comorbidities compared to patients who did not lose mobility (p<0.05). The presence of sepsis, number of intubated patients and use of vasoactive drugs was higher in patients with loss of mobility (p<0.05). After performing a COX regression model to evaluate the effects of variables on hospital mortality, the only factor independently associated with mortality was loss of mobility (OR 2.84, 95% confidence interval (CI) 1.50-5.39, p<0.001). <bold>Conclusion:</bold> Loss of mobility assessed by IMS scale may predict hospital mortality after ICU.