title: The surgical intensive care unit optimal mobility score predicts mortality and length of stay.
abstract: OBJECTIVE
  To test if the surgical intensive care unit optimal mobility score predicts mortality and intensive care unit and hospital length of stay.
  
  
  METHODS
  Prospective single-center cohort study.
  
  
  METHODS
  Surgical intensive care unit of the Massachusetts General Hospital.
  
  
  METHODS
  One hundred thirteen consecutive patients admitted to the surgical intensive care unit.
  
  
  METHODS
  We tested the hypotheses that the surgical intensive care unit optimal mobility score independent of comorbidity index, Acute Physiology and Chronic Health Evaluation II, creatinine, hypotension, hypernatremia, acidosis, hypoxia, and hypercarbia predicts hospital mortality, surgical intensive care unit and total hospital length of stay.
  
  
  RESULTS
  Two nurses independently predicted the patients' mobilization capacity by using the surgical intensive care unit optimal mobility score the morning after admission, whereas a third nurse recorded the achieved mobilization levels of patients at the end of the day. A multidisciplinary expert team measured patients' grip strength and assessed their predicted mobilization capacity independently. Multivariate analysis revealed that the surgical intensive care unit optimal mobility score was the only independent predictor of mortality. Surgical intensive care unit optimal mobility score, hypotension, and hypernatremia (>144 mmol/L) independently predicted intensive care unit length of stay, whereas the surgical intensive care unit optimal mobility score and hypernatremia predicted total hospital length of stay. The Acute Physiology and Chronic Health Evaluation II score was not identified in the multivariate analysis. The surgical intensive care unit optimal mobility score was also a reliable and valid instrument in predicting achieved mobilization levels of patients.
  
  
  CONCLUSIONS
  In surgical critically ill patients presenting without preexisting impairment of functional mobility, the surgical intensive care unit optimal mobility score is a reliable and valid tool to predict mortality and intensive care unit and hospital length of stay.
authors: Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
authors: George
authors: G
authors: Kasotakis
authors: Ulrich
authors: U
authors: Schmidt
authors: Dana
authors: D
authors: Perry
authors: Martina
authors: M
authors: Grosse-Sundrup
authors: John
authors: J
authors: Benjamin
authors: Cheryl
authors: C
authors: Ryan
authors: Susan
authors: S
authors: Tully
authors: Ronald
authors: R
authors: Hirschberg
authors: Karen
authors: K
authors: Waak
authors: George
authors: G
authors: Velmahos
authors: Edward A
authors: EA
authors: Bittner
authors: Ross
authors: R
authors: Zafonte
authors: J Perren
authors: JP
authors: Cobb
authors: Matthias
authors: M
authors: Eikermann
mesh_terms: D018806:APACHE; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018737:Hand Strength; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult