Michael Goldfarb1, Jonathan Afilalo2, Alice Chan3, Romana Herscovici4, Bojan Cercek4. 1. Divisions of Cardiology and Pulmonary and Critical Care, Cedars-Sinai Medical Center; Los Angeles, CA, United States. Electronic address: michael.j.goldfarb@mcgill.ca. 2. Division of Cardiology, Jewish General Hospital, McGill University; Montreal, QC, Canada. 3. Department of Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, United States. 4. Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Abstract
PURPOSE: Little is known about the effects of early mobilization in older adults in the Cardiovascular Intensive Care Unit (CICU). MATERIALS AND METHODS: We 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. RESULTS: There 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. CONCLUSIONS: EM 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.
PURPOSE: Little is known about the effects of early mobilization in older adults in the Cardiovascular Intensive Care Unit (CICU). MATERIALS AND METHODS: We 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. RESULTS: There 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. CONCLUSIONS: EM 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.
Authors: Naila Ijaz; Brian Buta; Qian-Li Xue; Denise T Mohess; Archana Bushan; Henry Tran; Wayne Batchelor; Christopher R deFilippi; Jeremy D Walston; Karen Bandeen-Roche; Daniel E Forman; Jon R Resar; Christopher M O'Connor; Gary Gerstenblith; Abdulla A Damluji Journal: J Am Coll Cardiol Date: 2022-02-08 Impact factor: 24.094