CAN MORTALITY OR ICU DISCHARGE IN CRITICALLY ILL PATIENTS BE PREDICTED BY FUNCTIONAL MOBILITY? A CROSS-SECTIONAL ANALYSIS OF CLINICAL AND VENTILATORY PARAMETERS

A patient’s status of remaining in the ICU, being discharged, or dying can be influenced by various clinical and functional factors. The role of functional mobility and infectious complications such as ventilator-associated pneumonia (VAP) is still little explored as a predictor of outcomes. To investigate the association between functional mobility, ventilatory parameters, VAP prevalence, and hospital outcome (discharge or death) in ICU patients on mechanical ventilation. This was a retrospective, analytical cross-sectional study. Adults (>18 years) of both sexes undergoing mechanical ventilation were included. Data related to hospitalization, mobility (Perme scale), ventilatory parameters, arterial blood gas, VAP prevalence, and outcomes were collected. Statistical analyses used Spearman or Pearson correlation coefficients, Mann-Whitney tests for comparisons, and binary logistic regression (Stepwise Backward method) to identify outcome predictors. Significance level was p < 0.05. The sample comprised 102 patients, aged 67±15 years; 47% were male; 8% had a diagnosis of VAP; and 54% died in the ICU. VAP was related to mobility (r = -0.27; p = 0.03) and PaO2/FiO2 ratio (r = -0.30; p = 0.01), while mobility was related to discharge outcome (r = 0.44; p < 0.01) and ventilatory mechanics (r = -0.33; p = 0.01). When stratified into discharge and death groups, there were statistically significant differences for ICU length of stay, mobility, and oxygenation (p < 0.01). Mean ICU stay was significantly longer among patients who died (14±11 days) compared with those discharged (9±7 days; p = 0.02). Mobility showed a statistically significant association with discharge (p = 0.007) and was the only independent predictor in logistic regression. Each additional point in the functional score increased the chance of discharge by 47% (OR = 1.47; 95% CI: 1.11–1.95). Functional mobility assessed by the Perme scale proved to be an independent predictor of ICU discharge in critically ill patients. This finding reinforces the importance of functional assessment and early mobilization of critically ill ICU patients as a complementary tool to traditional ventilatory parameters, with potential impact on clinical management and prognosis.