Mobility outcomes of patients with an Impella 5.5® device in the acute care setting.

BACKGROUND

The Impella 5.5® device is a temporary ventricular assist device that improves the cardiac output in patients with cardiogenic shock. These patients are critically ill and are often placed on bed rest, which can result in a functional decline. Early mobility programs have helped mitigate some of the negative consequences of immobility while also reducing the incidence of hospital-related complications.

OBJECTIVE

To describe the characteristics of patients with the Impella 5.5® device and to compare the initial mobility status of patients discharged home versus a post-acute facility.

METHODS

This retrospective cohort study examined 77 patients supported with the Impella 5.5® device in 2022. Data on demographic characteristics, medical interventions and functional outcomes were collected. The functional outcomes included the Activity Measure of Post-Acute Care Basic Mobility Short Form, the Functional Status Score for the Intensive Care Unit (ICU), the ICU Mobility Scale and the maximum ambulation distance.

RESULTS

The mean age was 58.7 years, with 74.2% of participants being male. Sixty-two patients received referrals for physical therapy, and 61/62 (98.4%) were able to be mobilized out of bed, with 74% (46/62) being able to ambulate while on the Impella 5.5®. Significant improvements were observed in all functional outcome measures by hospital discharge (p < .001). Patients discharged home were able to mobilize out of bed earlier (p < .001) and had higher functional outcomes scores compared to those discharged to a post-acute facility (p < .001).

CONCLUSIONS

Early mobilization is associated with improved function and a higher likelihood of being discharged home compared to a post-acute facility. The results of this study may help physical therapists working in the acute care setting be aware of the functional characteristics and progression of mobility in this patient population, which may assist therapists in developing a plan of care and determining discharge needs.