Impact of early mobilization on clinical and functional outcomes in patients submitted to coronary artery bypass grafting

Am J Cardiovasc Dis. 2022 Apr 15;12(2):67-72. eCollection 2022.

Abstract

Introduction: Heart surgery is a feature that has grown a lot in recent years. Due to the complications that can be generated, the importance of prevention emerges, thus seeking effective protocols that generate improvement in clinical and functional outcomes to promote a shorter hospital stay and readmission.

Objective: To evaluate the impact of early mobilization on clinical and functional outcomes in patients undergoing coronary artery bypass grafting.

Methodology: This was a prospective cohort study. Patients were evaluated preoperatively through the Medical Research Council (MRC), Functional Independence Measurement (FIM), Six-Minute Walk Test (6MWT). After the surgery they were divided into two groups: the mobilized group (MG) where patients performed bed transfer to armchair on the 1st postoperative day and ambulated on the 2nd day, and the non-mobilized group (NMG) who underwent passive kinesiotherapy in bed. At ICU discharge, mechanical ventilation (MV) time, intensive care unit stay (ICU) and mortality were compared. At hospital discharge, preoperative tests were repeated to compare with admission.

Results: A total of 103 patients were admitted, 59 (57.3%) males, mean age 64 ± 8 years. Time of MV it was 6 ± 2 (MG) vs 10 ± 3 (NMG) hours, P = 0.02, ICU stay it was 2 ± 2 (MG) vs 4 ± 3 (NMG) days (P ≤ 0.001), length of stay hospital was 8 ± 4 (MG) vs 14 ± 5 (NMG) days (P ≤ 0.001), FIM -4 ± 2 (MG) vs -11 ± 4 (NMG) points (P ≤ 0.001) and distance traveled 37 ± 10 (MG) vs 78 ± 11 (NMG) meters (P < 0.001).

Conclusion: Early mobilization is associated with improvement in clinical outcomes such as MV time, ICU stay, hospital and functional outcomes, on the FIM scale and distance traveled.

Keywords: Myocardial revascularization; early ambulation; physical therapy.