title: The Surgical Optimal Mobility Score predicts mortality and length of stay in an Italian population of medical, surgical, and neurologic intensive care unit patients.
abstract: OBJECTIVE
  We validated the Italian version of Surgical Optimal Mobility Score (SOMS) and evaluated its ability to predict intensive care unit (ICU) and hospital length of stay (LOS), and hospital mortality in a mixed population of ICU patients.
  
  
  METHODS
  We applied the Italian version of SOMS in a consecutive series of prospectively enrolled, adult ICU patients. Surgical Optimal Mobility Score level was assessed twice a day by ICU nurses and twice a week by an expert mobility team. Zero-truncated Poisson regression was used to identify predictors for ICU and hospital LOS, and logistic regression for hospital mortality. All models were adjusted for potential confounders.
  
  
  RESULTS
  Of 98 patients recruited, 19 (19.4%) died in hospital, of whom 17 without and 2 with improved mobility level achieved during the ICU stay. SOMS improvement was independently associated with lower hospital mortality (odds ratio, 0.07; 95% confidence interval [CI], 0.01-0.42) but increased hospital LOS (odds ratio, 1.21; 95% CI: 1.10-1.33). A higher first-morning SOMS on ICU admission, indicating better mobility, was associated with lower ICU and hospital LOS (rate ratios, 0.89 [95% CI, 0.80-0.99] and 0.84 [95% CI, 0.79-0.89], respectively).
  
  
  CONCLUSIONS
  The first-morning SOMS on ICU admission predicted ICU and hospital LOS in a mixed population of ICU patients. SOMS improvement was associated with reduced hospital mortality but increased hospital LOS, suggesting the need of optimizing hospital trajectories after ICU discharge.
authors: Department of Anesthesia, Critical Care Medicine and Emergency, Spedali Civili University Hospital, Brescia, Italy.
authors: Simone
authors: S
authors: Piva
authors: Department of Physical Medicine and Rehabilitation, Spedali Civili University Hospital, Brescia, Italy.
authors: Giancarlo
authors: G
authors: Dora
authors: National Heart and Lung Institute, Imperial College London, London, England, UK.
authors: Cosetta
authors: C
authors: Minelli
authors: Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
authors: Mariachiara
authors: M
authors: Michelini
authors: Department of Anesthesia, Critical Care Medicine and Emergency, Spedali Civili University Hospital, Brescia, Italy.
authors: Fabio
authors: F
authors: Turla
authors: Department of Anesthesia, Critical Care Medicine and Emergency, Spedali Civili University Hospital, Brescia, Italy.
authors: Stefania
authors: S
authors: Mazza
authors: Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
authors: Patrizia
authors: P
authors: D'Ottavi
authors: Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors: Ingrid
authors: I
authors: Moreno-Duarte
authors: Department of Physical Medicine and Rehabilitation, Spedali Civili University Hospital, Brescia, Italy.
authors: Caterina
authors: C
authors: Sottini
authors: Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors: Matthias
authors: M
authors: Eikermann
authors: Department of Anesthesia, Critical Care Medicine and Emergency, Spedali Civili University Hospital, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. Electronic address: nicola.latronico@unibs.it.
authors: Nicola
authors: N
authors: Latronico
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000534:rehabilitation*; D004434:Early Ambulation / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: Early mobilization; Mortality; Neurologic patients; Rehabilitation; Safety; Validation