Early Mobilization and Prolonged ICU Stay in Postoperative Patients

This is a prospective observational cohort study involving adult postoperative patients admitted to the intensive care unit (ICU). The study aims to systematically evaluate early mobilization practices and investigate the association between early mobilization and short-term clinical outcomes in postoperative ICU patients.

Mobilization performed within the first 24 hours after ICU admission will be evaluated according to predefined standardized criteria. Mobilization levels will be recorded using a scale ranging from passive movements to independent mobilization. Early meaningful mobilization is defined as achieving at least sitting at the edge of the bed (mobilization level ≥4) within the first 24 hours after ICU admission. Patients will be classified according to whether early meaningful mobilization is achieved.

The primary objective is to evaluate the association between early meaningful mobilization and prolonged ICU stay. Secondary objectives include evaluating its association with the requirement for and duration of mechanical ventilation, hospital length of stay, need for reintubation, development of delirium, complications occurring during mobilization, ICU mortality, and other early clinical outcomes.

Clinical factors potentially associated with the feasibility of early mobilization will also be evaluated. These include age, comorbidities, preoperative functional capacity, type and duration of surgery, APACHE II and SOFA scores at ICU admission, requirement for mechanical ventilation, vasopressor support, and sedation level. In patients who are not mobilized early, potential barriers to mobilization, including hemodynamic instability, respiratory insufficiency, deep sedation, pain, surgical restrictions, and organizational factors, will be recorded.

Patients will be followed throughout their ICU and hospital stay, and relevant clinical outcomes will be recorded. Demographic characteristics, surgical data, clinical parameters at ICU admission, mobilization status, and clinical outcomes will be collected using a standardized data collection form. All collected data will be anonymized for analysis.

No additional intervention or diagnostic test will be performed as part of the study. All study data will be obtained during routine clinical follow-up, directly from included patients, nursing observation forms, and electronic hospital records.

Inclusion criteria

• Age 18 years or older
• Admission to the intensive care unit for postoperative care
• ICU stay of at least 24 hours
• Ability to assess the patient's mobilization level within the first 24 hours following ICU admission
• Provision of informed consent for participation in the study

Exclusion criteria

• Age under 18 years
• Pregnancy
• Death within the first 24 hours after ICU admission
• Clinical conditions contraindicating mobilization, including active massive bleeding, significant hemodynamic instability, unstable fracture, open abdomen, or similar conditions