The Association of Maximum Hospital Daily Mobility After Open Cardiac Surgery and Patient Psychological Status, Surgical/Postoperative Factors, and Clinical Outcomes.

BACKGROUND

Mobility after cardiac surgery is facilitated using phase 1 cardiac rehabilitation. However, rehabilitation services may be limited, minimizing the full benefits of hospital-based early mobility.

OBJECTIVE

To examine patient, surgical, and postoperative factors and clinical outcomes associated with maximal postoperative daily mobility.

METHODS

A multisite, prospective, correlational design was used. Post intensive care unit stay, daily mobility was collected, patients completed psychological status surveys, and medical record data were retrieved. Maximum daily mobility level scores were recategorized into 4 groups; higher levels and groups represented greater mobility. Relationships between mobility category scores and patient factors were described using Spearman correlations (95% confidence intervals).

RESULTS

Participants (N = 650) had a median (25th-75th percentile) of 4.0 (3.0-5.0) non-intensive care days of mobility data. Of patients, 62 (9.5%) had very low mobility (<20 ft/day) and 419 (64.5%) achieved the highest mobility (>200 ft/day). Higher maximum daily mobility was associated with younger age, commercial insurance, lower body mass index, no history of myocardial infarction, heart failure, cerebrovascular disease or diabetes, higher hemoglobin/hematocrit, lower serum creatinine, and lower rates of prolonged ventilation (all P  < .05). Higher maximum daily mobility was associated with higher perceived general health ( P  = .003), shorter hospital length of stay ( P  = .009), and higher likelihood of discharge to home ( P  < .001). Day 4 mobility level was associated with lower 30-day rehospitalization, P  = .014.

CONCLUSION

Maximal daily mobility after cardiac surgery varied by multiple factors-many that were not directly focused on the ability to ambulate. Attention to achieving higher post-intensive care unit daily mobility levels is warranted.