Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Aug;156(2):316-322.
doi: 10.1016/j.chest.2019.04.001. Epub 2019 Apr 11.

Mobility Identifies Acutely Ill Patients at Low Risk of In-Hospital Mortality: A Prospective Multicenter Study

Christian H Nickel  1 , John Kellett  2 , Ricardo Nieves Ortega  1 , Le Lyngholm  3 , Lucien Wasingya-Kasereka  4 , Mikkel Brabrand  5
Affiliations
Observational Study

Mobility Identifies Acutely Ill Patients at Low Risk of In-Hospital Mortality: A Prospective Multicenter Study

Christian H Nickel et al. Chest. 2019 Aug.

Abstract

Background: A retrospective study has reported that impaired mobility on presentation (IMOP) enhanced the ability of vital signs to predict mortality in acutely ill patients. This study was designed to further examine the association between IMOP and in-hospital mortality.

Methods: Prospective observational study of three different cohorts of acutely ill patients admitted to hospitals in Esbjerg, Denmark (998 patients), Basel, Switzerland (743 patients), and Kitovu, Uganda (1,622 patients).

Results: There were significant differences in age, sex, length of stay, proportion of medical and surgical patients, and in-hospital mortality between the three cohorts. Yet in all three cohorts a National Early Warning Score (NEWS) ≥ 3 when first recorded and IMOP increased the risk of in-hospital mortality to approximately the same extent. IMOP and NEWS ≥ 3 when first recorded were, therefore, used for risk categorization: patients with a NEWS < 3 when first recorded and normal mobility on presentation had the lowest in-hospital mortality risk and those with NEWS ≥ 3 when first recorded and IMOP had the highest risk. The number of these low risk patients ranged from 26% in Kitovu to 42% in Esbjerg, and their in-hospital mortality rates did not significantly differ in all three cohorts, ranging from 0.2% in Esbjerg to 0.4% in Basel.

Conclusions: In this prospective multicenter study IMOP enhanced the risk categorization of acutely ill patients from very different clinical settings. The combination normal mobility on presentation and first recorded NEWS identified a substantial proportion of patients in all cohorts with a low risk of dying while in hospital.

Trial registry: The Esbjerg data were collected as part of a trial registered with the US National Library of Medicine (ClinicalTrials.gov; No.: NCT03108807; URL: www.clinicaltrials.gov).

Keywords: clinical decision making; early warning scores; frailty; mobility; risk assessment; vital signs.

PubMed Disclaimer

Publication types

Associated data