Mobility Loss in Hospitalized Adults Predicts Poor Clinical Outcomes.
Stephanie E. Rogers, Jade Mulvey, Roniela Turingan and 4 others
PMID 39977841WHAT IT FOUND
Hospitalized adults whose nurse-assessed mobility dropped by at least one level from admission to discharge were at higher risk of delirium, death, falls, facility discharge and longer stay, but not readmission.
Key findings
01Compared with no change in mobility, a loss of one or more JH-HLM levels was associated with 2 times higher risk of delirium and 7.2 times higher risk of in-hospital mortality.
02Mobility loss was associated with 1.5 times higher fall risk, 4.1 times higher discharge to a facility, and 48% longer length of stay.
03Mobility loss was not significantly associated with unplanned 30-day readmission.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study can only show association, not causation. A patient with delirium may move less, and immobility may also contribute to delirium. 14% of eligible encounters were excluded for missing data, and complete case analysis may bias results if missingness differed by mobility group. Patients at the lowest or highest mobility level on admission could not show loss or gain, which can hide true mobility change. A sensitivity analysis excluding these patients did not change the main pattern except mortality became larger. The study did not test whether daily mobility assessments, JH-HLM goals, or therapy changed outcomes.
The easy way to misread this
Do not read these associations as proof that mobilizing patients prevents delirium, death, falls, longer stay, or facility discharge. This was an observational study of mobility change, not a trial of mobility treatment, and it could not tell whether loss caused poor outcomes or poor outcomes caused loss.