B108-04 Admission Clinical Diagnosis Predicts Mobility Trajectories in Critically Ill Patients

Abstract Rationale The mobility trajectory of critically ill patients during intensive care unit (ICU) stay is influenced by several factors, including clinical diagnosis at admission and functional evolution. Understanding how clinical diagnostic categories affect clinical and mobility outcomes can support individualized management and performance monitoring in critical care. This study aimed to investigate the association between clinical diagnostic group and mobility trajectory, defined by changes in mobility status during ICU hospitalization. Methods This retrospective observational study included 785 adult patients admitted to a tertiary ICU. Only patients who were functionally independent before hospitalization were analyzed. Demographic, diagnostic, and mobility data were extracted from medical records and monitoring forms. The mobility trajectory was determined using the Johns Hopkins Highest Level of Mobility (JH-HLM) scale, which ranges from level 1 (bedbound) to level 8 (ambulation 10 feet). For each patient, the trajectory was defined as the difference between the maximum JH-HLM level achieved at ICU discharge and the pre-hospitalization level reported by the patient or family: improvement, maintenance, or worsening. Patients were categorized by clinical diagnostic group (e.g., cardiac, respiratory, oncologic, neurological, respiratory). Associations between diagnostic group and trajectory were assessed using Pearson’s chi-square test (p 0.05). Additional analyses examined associations with ICU length of stay, age, and sex. Results The mean age was 58.3 ± 15.6 years (range: 18–94), and 54% were male. Major diagnostic groups included Clinical Cardiology (22.9%), Surgical Cardiology (18.1%), General Surgery (15.5%), and Oncology (12.6%). The mean ICU stay was 5.2 ± 7.8 days (median: 3). Overall, 57.7% of patients worsened, 39.6% maintained, and 2.7% improved mobility during ICU stay. Orthostatism occurred in 74.9% of patients and ambulation in 61.4%. A significant association was observed between diagnostic group and mobility trajectory (χ² = 41.29; df = 18; p = 0.0014). Respiratory (70%), Vascular (76.3%), and Oncologic (68.7%) groups showed the highest rates of worsening, while Cardiac groups demonstrated more balanced outcomes. Length of stay was longer among patients with worsening trajectories (p = 0.031); age and sex were not associated. Conclusions Clinical diagnostic group significantly influences mobility trajectories in ICU patients. Respiratory, vascular, and oncologic diagnoses were linked to poorer outcomes, while cardiac and neurological cases showed more favorable evolution. Incorporating mobility-based metrics such as JH-HLM into routine assessment may enhance prognostic evaluation and quality improvement in critical care. This abstract is funded by: None