Level of mobility and time to first out of bed mobilization ina neurosurgical ICU - A Brief Report

Abstract

Background: Hospitalization in the Intensive Care Unit (ICU) can lead to long-term physical, cognitive, and psychological
impairments, collectively named Post-Intensive Care Syndrome. Individuals with acquired brain injury are at high risk, yet data
on ICU mobility in this population remain limited. Early mobilization may prevent complications and improve recovery, but
is challenging in neurocritical care. Objectives: To describe the level of mobility in a neurosurgical ICU and explore factors
associated with mobility outcomes. Methods: This single-center, retrospective observational study included adults hospitalized
>24 hours in a neurosurgical ICU. Daily mobility was recorded using the ICU Mobility Scale (IMS). Primary outcome was the
distribution of mobility levels. Secondary outcomes included frequency of out-of-bed mobilization, maximal IMS score, time from
in-bed to out-of-bed mobility, and factors influencing these outcomes. Results: Among 160 individuals included (median age 51
years (Q1-Q3 41–61), 45% female), 2,692 patient-days were analyzed. Median IMS was 1 (0-1). Out-of-bed mobilization
occurred on 17% of days and was achieved a median 4 days (2-7) after first in-bed mobility in 76% of cases. Median maximal
IMS during ICU stay was 5 (3-5). A higher initial Glasgow Coma Scale score was associated with a shorter time to out-of-bed
mobilization, and longer ICU stays were linked to delayed mobilization. Conclusions: Early mobilization in the neurosurgical
ICU is often limited, with most achieving out-of-bed mobility before discharge despite low maximal mobility levels. Further
studies on factors influencing mobility are needed to optimize the clinical impact of early mobilization in this population.