Level of mobility and time to first out of bed mobilization in a neurosurgery ICU

Level of mobility and time to first out of bed mobilization in a neurosurgery ICU | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Level of mobility and time to first out of bed mobilization in a neurosurgery ICU Henri de Noray, Audrey Lallemant, Cloé Commeau, Vincent Degos, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7272814/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The objective of this observational study was to describe the usual practices of mobilization in a neurosurgical ICU during a specific period, through daily mobility level of patients. This retrospective cohort study was conducted in a single ICU, where data from a six-month period from January to June of 2024 were collected from patients’ medical records. For each day of stay in the ICU, the maximum level of mobility was described using the French version of the ICU Mobility Scale (IMS) 10,11 . The primary outcome of the study was the median time between the first day of active mobility in bed, IMS=1, and the first day of Out-Of-Bed mobilization (OOB), considered as IMS>1. Secondary outcomes to describe mobility were frequency of OOB, and maximal IMS reached during the ICU stay. Baseline characteristics were also reported. To conclude, in people who regained active mobility in a neurosurgery ICU, 76% received at least one OOB mobilization during their stay and median time between first in bed active mobility and OOB mobility was 4 (2-7) days. Main text Hospitalization in Intensive Care Unit (ICU) has long-term consequences on patient health status and quality of life such as physical impairment, pain, fatigue, cognitive, and psychological problems. These chronic symptoms have been described as Post-Intensive Care Syndrome (PICS) 1 . People with acquired brain injury (ABI) are less represented in PICS studies, as it might be difficult to separate issues induced by the ICU from those caused by the neurological disease 2 . Nevertheless, people with ABI who stayed in ICU have even higher probability of presenting physical, cognitive and psychological symptoms at the chronic stage. In order to prevent these, several strategies have been developed and incorporated in a “liberation from ICU” bundle of care of six categories: ABCDEF 3 . Early mobility and exercise are the fifth item of the bundle. They aim to prevent physical disorders, such as bed rest complications, as well as cognitive and psychological issues. Even if it seems to be a common practice, its implementation can be challenging. Indeed, early mobilization depends on the number of available nurses and rehabilitation therapists, mobilization devices, adapted rooms, and the presence of medical devices around the patient (ventilation, lines, …) 4,5 . Some additional specific difficulties are related to neuro-critical care, such as ensuring the best cerebral perfusion, presence of external ventricular drains or intracranial monitoring 2 . Several protocols have been created to guide early mobilization 6 . According to patient’s stability judged through a set of clinical indicators, mobility should be progressively implemented. Thus, these protocols allow the individualization of mobility levels. Studies on ABI patients reported that early progressive mobilization, would probably have a positive effect on functional recovery 7,8 . However, a very early (<24h from admission) and intensive mobilization may have a negative effect on function recovery, as shown in stroke patients 9 . The objective of this observational study was to describe the usual practices of mobilization in a neurosurgical ICU during a specific period, through daily mobility level of patients. This retrospective cohort study was conducted in a single ICU, where data from a six-month period from January to June of 2024 were collected from patients’ medical records. For each day of stay in the ICU, the maximum level of mobility was described using the French version of the ICU Mobility Scale (IMS) 10,11 . The primary outcome of the study was the median time between the first day of active mobility in bed, IMS=1, and the first day of Out-Of-Bed mobilization (OOB), considered as IMS>1. Secondary outcomes to describe mobility were frequency of OOB, and maximal IMS reached during the ICU stay. Baseline characteristics were also reported. Subjects were eligible for inclusion if they were over 18 years old on the day of their admission and hospitalized for more than 24 hours in the neurosurgery ICU, during the six-month period between January 2024 and June 2024. They were excluded if the description of the primary outcome was not possible (death or discharge before reaching IMS=1, already reached IMS=1 on the first day of the study). This study has been conducted in accordance with the Helsinki declaration and current French law. It was approved by the research ethic committee Comité Ethique de Recherche en Anesthésie et Réanimation (CERAR), which waived the need for a formal consent (IRB: 00010254 ‐ 2025 – 035). Based on a previous study 11 , we estimated that OOB mobilization should be observed in 45% of patients. A required sample size of 199 was calculated with G*Power in order to detect a potential two-tailed difference in proportion of 10%, with an alpha risk of 5% and beta of 20%. In our 25-bed ICU, considering a median length of stay of 20 days, a six-month period was estimated appropriate for the study. Statistical analysis was conducted using the version 4.3.3 of the R software. Descriptive results were presented as numbers and percentages for categorical variables, and median with interquartile range for quantitative variables. Chi-squared tests were used to compare subgroups for qualitative variables, and Fisher’s exact test when not applicable. For quantitative variables, Kruskal-Wallis test was used. Occurrence of OOB mobilization during the stay was explored through a logistic regression, and time to reach this outcome using Cox regression. Over the six-month period of the study, 218 adult patients remained more than 24 hours in the ICU and were eligible for inclusion. Among them, 58 were excluded either because they never reached IMS=1 during their stay (n=47), or because they already reached IMS=1 at the onset of the considered period (n=11). Finally, 160 patients were included in the analysis, with a median age of 51 (41-61), 44% women, median BMI of 24.9 (22.2-28.3), median ASA score of 2 (1-3), median initial Glasgow coma scale (GCS) of 14 (8-15), duration of mechanical ventilation of 0 day (0-8), and a length of stay in ICU of 14 days (6-22). Most people were admitted for a subarachnoid hemorrhage (n=50), secondly for a traumatic brain injury (n=35), and thirdly for an intracerebral hemorrhage (n=19). Other reasons for admissions are detailed in Table 1 . Seven included subjects died in ICU (4%), 117 (73%) were discharged to the neurosurgery ward, 17 to the neurovascular ICU (11%), and 15 (9%) to other places. Table 1. Patient’s characteristics according to reason for admission Variable SAH (n=50) TBI (n=35) ICH (n=19) BT (n=17) IS (n=13) Other (n=26) p Age 52 [40-60] 46 [27-57] 55 [34-64] 54 [48-63] 59 [48-66] 50 [46-60] 0.07783 † Sex (female) 34 (68) 5 (14) 7 (37) 8 (47) 4 (31) 14 (54) <0.01 ‡ BMI 25 [22-29] 25 [22-28] 23 [22-27] 25 [23-34] 25 [25-28] 25 [22-31] 0.5934 † ASA score 2 [1-2] 2 [1-2] 1 [1-3] 2.5 [2-3] 2 [2-3] 2 [2-3] 0.6229 † GCS initial 15 [14-15] 8 [6-13] 12 [11-15] 14 [11-15] 13 [10-14] 15 [8-15] <0.01† DMV 0 [0-3] 7 [1-24] 3 [0-8.5] 0 [0-7.5] 0 [0-6] 0 [0-5] <0.01† ICU LOS 17 [9-21] 15 [7-28] 10 [6-19] 15 [7-28] 10 [5-14] 7 [3-18] 0.0594 † OOB during stay 43 (88) 24 (69) 17 (90) 12 (71) 11 (85) 15 (58) <0.01º Time from: - Admission to IMS=1 0 [0-1] 6 [1-16] 1 [0-5] 0 [0-4] 0 [0-1] 1 [0-3] 1 3 [2-8] 4.5 [4-6] 4 [3-7] 3 [1-6] 4 [4-6] 3 [2-5] 0.582 † Number of OOB days 3 [1-5] 2 [0-3] 1 [0-2] 1 [0-2] 2 [1-4] 1 [0-3] <0.01† IMS max during stay 5 [3-6] 3 [1-5] 5 [3-5] 3 [1-4] 5 [3-5] 3 [1-5] <0.05† ASA: American Society of Anesthesiologists BMI: Body Mass Index BT: Brain Tumor DMV: Duration of Mechanical Ventilation GCS: Glasgow Coma Scale ICH: Intracerebral Hemorrhage ICU: Intensive Care Unit IMS: ICU Mobility Scale IS: Ischemic Stroke LOS: Length of Stay OOB: Out of Bed SAH: Subarachnoid Hemorrhage TBI: Traumatic Brain Injury †: Kruskal-Wallis Test ‡: Chi-square test º: Fisher exact test The sum of the lengths of stay was 2719 days. We reported an IMS score for 2692 days, so there were less than 1% of missing data. The distribution of the IMS was not normal, with 2241 (83.2%) days with a maximal mobility either of 0 or 1 (see Supplemental File). OOB mobilization was observed in 452 (16.8%) days. Not all patients were mobilized out of bed, as only 122 (76%) of them reached an IMS score >1. The median time from admission to first active mobility in bed (IMS=1) was 1 (0-6) day, and the median time from this endpoint to the first out of bed mobility (IMS>1) was 4 (2-7) days (see Supplemental File). Each patient had a median number of OOB days of 2 (1-4), and the median maximal IMS reached was 5 (3-5), corresponding to an active transfer from the bed to the chair through standing with or without help, but with less than 6 steps. When comparing these mobility outcomes according to the reason for admission, time between IMS=1 to IMS>1 was the only outcome without any statistical difference ( Table 1 ). Patients with subarachnoid hemorrhage and intracerebral hemorrhage were more likely to have an OOB day during their stay, which was confirmed in a logistic regression with respective odds ratios of 4.54 (1.49-18.07) and 6.04 (1.26-45.17) ( Table 2 ). Table 2. Logistic regression to explain probability of out of bed mobilization Univariate analysis Multivariate analysis Variables OR (CI95) p OR (CI95) p Age 1.00 (0.98-1.03) 0.711 1.01(0.98-1.04) 0.5463 Sex 1.04 (0.50-2.21) 0.9129 0.79 (0.32-1.95) 0.6082 BMI 1.02 (0.96-1.09) 0.597 - - ASA score 0.94 (0.67-1.36) 0.73918 - - GCS initial 0.98 (0.89-1.07) 0.6658 0.99 (0.87-1.11) 0.8167 ICU LOS 1.06 (1.02-1.10) <0.001 1.05 (1.01-1.10) <0.05 DMV 1.01 (0.99-1.04) 0.59 - - Reason for admission SAH 5.26 (1.71-17.70) <0.001 4.54 (1.49-18.07) <0.05 IS 4.03 (0.85-29.59) 0.10697 3.47 (0.68-26.72) 0.1669 ICH 6.23 (1.29-44.65) <0.05 6.04 (1.26-45.17) <0.05 BT 1.76 (0.49-6.89) 0.39457 1.48 (0.37-6.23) 0.5825 TBI 1.60 (0.56-4.66) 0.38291 1.08 (0.31-3.64) 0.9073 ASA: American Society of Anesthesiologists BMI: Body Mass Index BT: Brain Tumor CI95: 95% Confidence Interval DMV: Duration of Mechanical Ventilation GCS: Glasgow Coma Scale ICH: Intracerebral Hemorrhage ICU: Intensive Care Unit IS: Ischemic Stroke LOS: Length of Stay OR: Odds Ratio SAH: Subarachnoid Hemorrhage TBI: Traumatic Brain Injury In the univariate analysis to explain time from first active mobility in bed to first out of bed mobility, we found that a higher initial GCS was associated with a shorter delay (OR=1.06), and length of stay and duration of mechanical ventilation with longer delays (OR=0.98) ( Table 3 ). There was a collinearity between duration of mechanical ventilation and length of stay, and only length of stay was kept in the multivariate analysis. Effects of initial GCS and length of stay remained in the multivariate analysis with respective OR of 1.07 (1.01-1.13) and 0.98 (0.96-0.99), and there was a trend for a longer delay in women and people admitted for subarachnoid hemorrhage -two correlated variables-. Table 3. Cox regression to explain time from IMS=1 to IMS>1 Univariate analysis Multivariate analysis Variables HR (CI95) p HR (CI95) p Age 1.01 (0.99-1.02) 0.103 1.01 (0.99-1.02) 0.11570 Sex 0.83 (0.57-1.19) 0.306 0.67 (0.43-1.04) 0.07678 BMI 1.01 (0.99-1.04) 0.311 - - ASA score 1.02 (0.89-1.18) 0.776 - - GCS initial 1.06 (1.01-1.11) <0.05 1.07 (1.01-1.13) <0.05 ICU LOS 0.98 (0.96-0.99) <0.01 0.98 (0.96-0.99) <0.01 DMV 0.98 (0.97-0.99) <0.05 - - Reason for admission SAH 0.67 (0.37-1.22) 0.190 0.56 (0.30-1.06) 0.07680 IS 0.69 (0.32-1.51) 0.354 0.53 (0.23-1.22) 0.13473 ICH 0.81 (0.40-1.62) 0.543 0.59 (0.28-1.22) 0.15461 BT 0.66 (0.30-1.46) 0.307 0.84 (0.37-1.88) 0.66516 TBI 0.65 (0.34-1.25) 0.198 0.76 (0.37-1.56) 0.45774 ASA: American Society of Anesthesiologists BMI: Body Mass Index BT: Brain Tumor CI95: 95% Confidence Interval DMV: Duration of Mechanical Ventilation GCS: Glasgow Coma Scale HR: Hazard Ratio ICH: Intracerebral Hemorrhage ICU: Intensive Care Unit IS: Ischemic Stroke LOS: Length of Stay IMS: ICU Mobility Scale SAH: Subarachnoid Hemorrhage TBI: Traumatic Brain Injury This observational research found that OOB occurred in 16.8% of observed days, which was lower than the 40% expected 11 , although that estimate considered ICUs beyond just neurosurgery. The median time separating first active in-bed mobility from first out of bed mobilization was 4 days, and no prior expectation had been established for this outcome. This timing was associated with initial GCS, duration of mechanical ventilation and length of stay, thus indicating that the initial severity of the condition is the main factor to delay out of bed mobilization. Also, there was no significant difference in this timing across diagnostic subgroups, although a slight trend for a longer delay in SAH subjects. Therefore, the out of bed mobility cannot be considered as very early (before 24h), but yet is earlier than the typical onset of vasospasm. Regarding the presence of OOB mobilization along the stay, it is not associated with initial severity, but with a longer ICU stay. Before their discharge, some patients probably don’t receive an OOB mobilization even if they are capable of it. This could be explained by a stay that was too short and the mobilization then seen as a burden rather than a priority. This study has some limitations. The included population was smaller than the foreseen required sample size, potentially impacting achieved power of the study. Also, interpretation of our results should be aware of the selection of the population and exclusion of people who would have had the lowest level of mobility, though underestimating how limited mobility is in neurosurgery ICU patients. Reporting other specific considerations for acquired brain injuries patients could have led to a better comprehension of mobility outcomes, such as polytrauma, external ventricular drainage, vasospasm, or cognitive impairments. To conclude, in people who regained active mobility in a neurosurgery ICU, 76% received at least one OOB mobilization during their stay and median time between first in bed active mobility and OOB mobility was 4 (2-7) days. Abbreviations ABI: Acquired Brain Injury GCS: Glasgow Coma Scale ICU: Intensive Care Unit IMS: ICU Mobility Scale OOB: Out-Of-Bed OR: Odd ratio PICS: Post Intensive Care Syndrome Declarations 1) The manuscript was verified to comply with all instructions to authors. 2) Authors contributions: - HDN: Conceptualization; Methodology; Investigation; Formal Analysis; Writing Original Draft - AL: Investigation; Writing Original Draft - CC: Investigation; Writing Original Draft - VD: Supervision; Conceptualization; Methodology - AJ: Supervision; Conceptualization; Methodology; Formal Analysis; Writing Original Draft 3) All authors reviewed the manuscript 4) All authorships have been met and the final manuscript was approved by all authors. 5) The manuscript has not been published elsewhere and is not under consideration by another journal. 6) This study has been conducted in accordance with the 1964 Helsinki declaration and current French law. It was approved by the research ethic committee Comité Ethique de Recherche en Anesthésie et Réanimation (CERAR), IRB: 00010254 ‐ 2025 – 035. For this retrospective study, formal consent was not required, and waived by the ethic committee. 7) The authors declare that they have no conflict of interest. 8) Strobe checklist was used and is included at the end of the manuscript. 9) This study received funding from the University-Hospital of Bordeaux, France, in order to cover the article processing charges for an Open Access submission. References Needham DM, Davidson J, Cohen H et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference. Crit Care Med . 2012;40(2):502–509. 10.1097/CCM.0b013e318232da75 LaBuzetta JN, Rosand J, Vranceanu AM, Review. Post-Intensive Care Syndrome: Unique Challenges in the Neurointensive Care Unit. Neurocrit Care. 2019;31(3):534–45. 10.1007/s12028-019-00826-0 . Marra A, Ely EW, Pandharipande PP, Patel MB. The ABCDEF Bundle in Critical Care. Crit Care Clin. 2017;33(2):225–43. 10.1016/j.ccc.2016.12.005 . Brock C, Marzano V, Green M, et al. Defining new barriers to mobilisation in a highly active intensive care unit – have we found the ceiling? An observational study. Heart Lung. 2018;47(4):380–5. 10.1016/j.hrtlng.2018.04.004 . Raurell-Torredà M, Arias-Rivera S, Martí JD, et al. Variables associated with mobility levels in critically ill patients: A cohort study. Nurs Crit Care. 2022;27(4):546–57. 10.1111/nicc.12639 . Lang JK, Paykel MS, Haines KJ, Hodgson CL. Clinical Practice Guidelines for Early Mobilization in the ICU: A Systematic Review. Crit Care Med. 2020;48(11). 10.1097/CCM.0000000000004574 . Yen HC, Chuang HJ, Hsiao WL, et al. Assessing the impact of early progressive mobilization on moderate-to-severe traumatic brain injury: a randomized controlled trial. Crit Care Lond Engl. 2024;28(1):172. 10.1186/s13054-024-04940-0 . Foudhaili A, Leclere B, Martinache F, Chauvin A, Vitiello D, Chousterman B. Early mobilization in patients with aneurysmal subarachnoid haemorrhage may im-prove functional status and reduce cerebral vasospasm rate: a systematic review with meta-analysis. J Rehabil Med. 2024;56:jrm41225. 10.2340/jrm.v56.41225 . Langhorne P, Wu O, Rodgers H, Ashburn A, Bernhardt J. A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial. Health Technol Assess Winch Engl. 2017;21(54):1–120. 10.3310/hta21540 . Hodgson C, Needham D, Haines K, et al. Feasibility and inter-rater reliability of the ICU Mobility Scale. Heart Lung. 2014;43(1):19–24. 10.1016/j.hrtlng.2013.11.003 . de Noray H, Kaïm AE, Blanchard F, Jacquens A. ICU Mobility Scale translation to French and validation. Anaesth Crit Care Pain Med . Published online May 1, 2025:101532. 10.1016/j.accpm.2025.101532 STROBE, Statement. 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These chronic symptoms have been described as Post-Intensive Care Syndrome (PICS) \u003csup\u003e1\u003c/sup\u003e. People with acquired brain injury (ABI) are less represented in PICS studies, as it might be difficult to separate issues induced by the ICU from those caused by the neurological disease \u003csup\u003e2\u003c/sup\u003e. Nevertheless, people with ABI who stayed in ICU have even higher probability of presenting physical, cognitive and psychological symptoms at the chronic stage.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn order to prevent these, several strategies have been developed and incorporated in a \u0026ldquo;liberation from ICU\u0026rdquo; bundle of care of six categories: ABCDEF \u003csup\u003e3\u003c/sup\u003e. Early mobility and exercise are the fifth item of the bundle. They aim to prevent physical disorders, such as bed rest complications, as well as cognitive and psychological issues. Even if it seems to be a common practice, its implementation can be challenging. Indeed, early mobilization depends on the number of available nurses and rehabilitation therapists, mobilization devices, adapted rooms, and the presence of medical devices around the patient (ventilation, lines, \u0026hellip;) \u003csup\u003e4,5\u003c/sup\u003e. Some additional specific difficulties are related to neuro-critical care, such as ensuring the best cerebral perfusion, presence of external ventricular drains or intracranial monitoring \u003csup\u003e2\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSeveral protocols have been created to guide early mobilization \u003csup\u003e6\u003c/sup\u003e. According to patient\u0026rsquo;s stability judged through a set of clinical indicators, mobility should be progressively implemented. Thus, these protocols allow the individualization of mobility levels. Studies on ABI patients reported that early progressive mobilization, would probably have a positive effect on functional recovery \u003csup\u003e7,8\u003c/sup\u003e. However, a very early (\u0026lt;24h from admission) and intensive mobilization may have a negative effect on function recovery, as shown in stroke patients \u003csup\u003e9\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe objective of this observational study was to describe the usual practices of mobilization in a neurosurgical ICU during a specific period, through daily mobility level of patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis retrospective cohort study was conducted in a single ICU, where data from a six-month period from January to June of 2024 were collected from patients\u0026rsquo; medical records. For each day of stay in the ICU, the maximum level of mobility was described using the French version of the ICU Mobility Scale (IMS) \u003csup\u003e10,11\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe primary outcome of the study was the median time between the first day of active mobility in bed, IMS=1, and the first day of Out-Of-Bed mobilization (OOB), considered as IMS\u0026gt;1. Secondary outcomes to describe mobility were frequency of OOB, and maximal IMS reached during the ICU stay. Baseline characteristics were also reported.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSubjects were eligible for inclusion if they were over 18 years old on the day of their admission and hospitalized for more than 24 hours in the neurosurgery ICU, during the six-month period between January 2024 and June 2024. They were excluded if the description of the primary outcome was not possible (death or discharge before reaching IMS=1, already reached IMS=1 on the first day of the study).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study has been conducted in accordance with the Helsinki declaration and current French law. It was approved by the research ethic committee \u003cem\u003eComit\u0026eacute; Ethique de Recherche en Anesth\u0026eacute;sie et R\u0026eacute;animation\u003c/em\u003e (CERAR), which waived the need for a formal consent (IRB: 00010254\u0026nbsp;‐\u0026nbsp;2025 \u0026ndash; 035).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBased on a previous study \u003csup\u003e11\u003c/sup\u003e, we estimated that OOB mobilization should be observed in 45% of patients. A required sample size of 199 was calculated with G*Power in order to detect a potential two-tailed difference in proportion of 10%, with an alpha risk of 5% and beta of 20%. In our 25-bed ICU, considering a median length of stay of 20 days, a six-month period was estimated appropriate for the study.\u003c/p\u003e\n\u003cp\u003eStatistical analysis was conducted using the version 4.3.3 of the R software. Descriptive results were presented as numbers and percentages for categorical variables, and median with interquartile range for quantitative variables. Chi-squared tests were used to compare subgroups for qualitative variables, and Fisher\u0026rsquo;s exact test when not applicable. For quantitative variables, Kruskal-Wallis test was used. Occurrence of OOB mobilization during the stay was explored through a logistic regression, and time to reach this outcome using Cox regression.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOver the six-month period of the study, 218 adult patients remained more than 24 hours in the ICU and were eligible for inclusion. Among them, 58 were excluded either because they never reached IMS=1 during their stay (n=47), or because they already reached IMS=1 at the onset of the considered period (n=11). Finally, 160 patients were included in the analysis, with a median age of 51 (41-61), 44% women, median BMI of 24.9 (22.2-28.3), median ASA score of 2 (1-3), median initial Glasgow coma scale (GCS) of 14 (8-15), duration of mechanical ventilation of 0 day (0-8), and a length of stay in ICU of 14 days (6-22). Most people were admitted for a subarachnoid hemorrhage (n=50), secondly for a traumatic brain injury (n=35), and thirdly for an intracerebral hemorrhage (n=19). Other reasons for admissions are detailed in \u003cstrong\u003eTable 1\u003c/strong\u003e. Seven included subjects died in ICU (4%), 117 (73%) were discharged to the neurosurgery ward, 17 to the neurovascular ICU (11%), and 15 (9%) to other places.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"667\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 667px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003ePatient\u0026rsquo;s characteristics according to reason for admission\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eSAH\u003c/p\u003e\n \u003cp\u003e(n=50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eTBI\u003c/p\u003e\n \u003cp\u003e(n=35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003eICH\u003c/p\u003e\n \u003cp\u003e(n=19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eBT\u003c/p\u003e\n \u003cp\u003e(n=17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eIS\u003c/p\u003e\n \u003cp\u003e(n=13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003cp\u003e(n=26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e52 [40-60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e46 [27-57]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e55 [34-64]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e54 [48-63]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e59 [48-66]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e50 [46-60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.07783\u003cstrong\u003e\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eSex (female)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e34 (68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e5 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e7 (37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e8 (47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e4 (31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e14 (54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u0026Dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e25 [22-29]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e25 [22-28]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e23 [22-27]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e25 [23-34]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e25 [25-28]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e25 [22-31]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.5934\u003cstrong\u003e\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eASA score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e2 [1-2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e2 [1-2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1 [1-3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e2.5 [2-3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e2 [2-3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e2 [2-3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.6229\u003cstrong\u003e\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eGCS initial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e15 [14-15]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e8 [6-13]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e12 [11-15]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e14 [11-15]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e13 [10-14]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e15 [8-15]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eDMV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0 [0-3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e7 [1-24]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3 [0-8.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0 [0-7.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0 [0-6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0 [0-5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eICU LOS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e17 [9-21]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e15 [7-28]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e10 [6-19]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e15 [7-28]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e10 [5-14]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e7 [3-18]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.0594\u003cstrong\u003e\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eOOB during stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e43 (88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e24 (69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e17 (90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e12 (71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e11 (85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e15 (58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026ordm;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eTime from:\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e- Admission to IMS=1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0 [0-1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e6 [1-16]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1 [0-5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0 [0-4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0 [0-1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e1 [0-3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003e- IMS=1 to IMS\u0026gt;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e3 [2-8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e4.5 [4-6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e4 [3-7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e3 [1-6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e4 [4-6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e3 [2-5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.582\u003cstrong\u003e\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eNumber of OOB days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e3 [1-5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e2 [0-3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1 [0-2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e1 [0-2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e2 [1-4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e1 [0-3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 157px;\"\u003e\n \u003cp\u003eIMS max during stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e5 [3-6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e3 [1-5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 76px;\"\u003e\n \u003cp\u003e5 [3-5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e3 [1-4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e5 [3-5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e3 [1-5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.05\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 345px;\"\u003e\n \u003cp\u003eASA: American Society of Anesthesiologists\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eBMI: Body Mass Index\u003c/p\u003e\n \u003cp\u003eBT: Brain Tumor\u003c/p\u003e\n \u003cp\u003eDMV: Duration of Mechanical Ventilation\u003c/p\u003e\n \u003cp\u003eGCS: Glasgow Coma Scale\u003c/p\u003e\n \u003cp\u003eICH: Intracerebral Hemorrhage\u003c/p\u003e\n \u003cp\u003eICU: Intensive Care Unit\u003c/p\u003e\n \u003cp\u003eIMS: ICU Mobility Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 322px;\"\u003e\n \u003cp\u003eIS: Ischemic Stroke\u003c/p\u003e\n \u003cp\u003eLOS: Length of Stay\u003c/p\u003e\n \u003cp\u003eOOB: Out of Bed\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eSAH: Subarachnoid Hemorrhage\u003c/p\u003e\n \u003cp\u003eTBI: Traumatic Brain Injury\u003c/p\u003e\n \u003cp\u003e\u0026dagger;: Kruskal-Wallis Test\u003c/p\u003e\n \u003cp\u003e\u0026Dagger;: Chi-square test\u003c/p\u003e\n \u003cp\u003e\u0026ordm;: Fisher exact test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe sum of the lengths of stay was 2719 days. We reported an IMS score for 2692 days, so there were less than 1% of missing data. The distribution of the IMS was not normal, with 2241 (83.2%) days with a maximal mobility either of 0 or 1 (see Supplemental File). OOB mobilization was observed in 452 (16.8%) days. Not all patients were mobilized out of bed, as only 122 (76%) of them reached an IMS score \u0026gt;1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe median time from admission to first active mobility in bed (IMS=1) was 1 (0-6) day, and the median time from this endpoint to the first out of bed mobility (IMS\u0026gt;1) was 4 (2-7) days (see Supplemental File).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEach patient had a median number of OOB days of 2 (1-4), and the median maximal IMS reached was 5 (3-5), corresponding to an active transfer from the bed to the chair through standing with or without help, but with less than 6 steps. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWhen comparing these mobility outcomes according to the reason for admission, time between IMS=1 to IMS\u0026gt;1 was the only outcome without any statistical difference (\u003cstrong\u003eTable 1\u003c/strong\u003e). Patients with subarachnoid hemorrhage and intracerebral hemorrhage were more likely to have an OOB day during their stay, which was confirmed in a logistic regression with respective odds ratios of 4.54 (1.49-18.07) and 6.04 (1.26-45.17) (\u003cstrong\u003eTable 2\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"595\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 595px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Logistic regression to explain probability of out of bed mobilization\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eUnivariate analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 246px;\"\u003e\n \u003cp\u003eMultivariate analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eOR (CI95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eOR (CI95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00 (0.98-1.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.711\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.01(0.98-1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.5463\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.04 (0.50-2.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.9129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.79 (0.32-1.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.6082\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.02 (0.96-1.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.597\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eASA score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.94 (0.67-1.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.73918\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eGCS initial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.98 (0.89-1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.6658\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.99 (0.87-1.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.8167\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eICU LOS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.06 (1.02-1.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.05 (1.01-1.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eDMV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.01 (0.99-1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 595px;\"\u003e\n \u003cp\u003eReason for admission\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eSAH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5.26 (1.71-17.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e4.54 (1.49-18.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eIS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.03 (0.85-29.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.10697\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e3.47 (0.68-26.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.1669\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eICH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e6.23 (1.29-44.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e6.04 (1.26-45.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eBT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.76 (0.49-6.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.39457\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.48 (0.37-6.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.5825\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eTBI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.60 (0.56-4.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.38291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.08 (0.31-3.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.9073\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 298px;\"\u003e\n \u003cp\u003eASA: American Society of Anesthesiologists\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eBMI: Body Mass Index\u003c/p\u003e\n \u003cp\u003eBT: Brain Tumor\u003c/p\u003e\n \u003cp\u003eCI95: 95% Confidence Interval\u003c/p\u003e\n \u003cp\u003eDMV: Duration of Mechanical Ventilation\u003c/p\u003e\n \u003cp\u003eGCS: Glasgow Coma Scale\u003c/p\u003e\n \u003cp\u003eICH: Intracerebral Hemorrhage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 298px;\"\u003e\n \u003cp\u003eICU: Intensive Care Unit\u003c/p\u003e\n \u003cp\u003eIS: Ischemic Stroke\u003c/p\u003e\n \u003cp\u003eLOS: Length of Stay\u003c/p\u003e\n \u003cp\u003eOR: Odds Ratio\u003c/p\u003e\n \u003cp\u003eSAH: Subarachnoid Hemorrhage\u003c/p\u003e\n \u003cp\u003eTBI: Traumatic Brain Injury\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIn the univariate analysis to explain time from first active mobility in bed to first out of bed mobility, we found that a higher initial GCS was associated with a shorter delay (OR=1.06), and length of stay and duration of mechanical ventilation with longer delays (OR=0.98) (\u003cstrong\u003eTable 3\u003c/strong\u003e). There was a collinearity between duration of mechanical ventilation and length of stay, and only length of stay was kept in the multivariate analysis. Effects of initial GCS and length of stay remained in the multivariate analysis with respective OR of 1.07 (1.01-1.13) and 0.98 (0.96-0.99), and there was a trend for a longer delay in women and people admitted for subarachnoid hemorrhage -two correlated variables-.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"586\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 586px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eCox regression to explain time from IMS=1 to IMS\u0026gt;1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eUnivariate analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eMultivariate analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eHR (CI95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eHR (CI95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.01 (0.99-1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.01 (0.99-1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.11570\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.83 (0.57-1.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.306\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.67 (0.43-1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.07678\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.01 (0.99-1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eASA score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.02 (0.89-1.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.776\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eGCS initial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.06 (1.01-1.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.07 (1.01-1.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eICU LOS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.98 (0.96-0.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.98 (0.96-0.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eDMV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.98 (0.97-0.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 586px;\"\u003e\n \u003cp\u003eReason for admission\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eSAH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.67 (0.37-1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.56 (0.30-1.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.07680\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eIS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.69 (0.32-1.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.354\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.53 (0.23-1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.13473\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eICH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.81 (0.40-1.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.543\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.59 (0.28-1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.15461\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eBT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.66 (0.30-1.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.307\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.84 (0.37-1.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.66516\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eTBI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.65 (0.34-1.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.76 (0.37-1.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.45774\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eASA: American Society of Anesthesiologists\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eBMI: Body Mass Index\u003c/p\u003e\n \u003cp\u003eBT: Brain Tumor\u003c/p\u003e\n \u003cp\u003eCI95: 95% Confidence Interval\u003c/p\u003e\n \u003cp\u003eDMV: Duration of Mechanical Ventilation\u003c/p\u003e\n \u003cp\u003eGCS: Glasgow Coma Scale\u003c/p\u003e\n \u003cp\u003eHR: Hazard Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eICH: Intracerebral Hemorrhage\u003c/p\u003e\n \u003cp\u003eICU: Intensive Care Unit\u003c/p\u003e\n \u003cp\u003eIS: Ischemic Stroke\u003c/p\u003e\n \u003cp\u003eLOS: Length of Stay\u003c/p\u003e\n \u003cp\u003eIMS: ICU Mobility Scale\u003c/p\u003e\n \u003cp\u003eSAH: Subarachnoid Hemorrhage\u003c/p\u003e\n \u003cp\u003eTBI: Traumatic Brain Injury\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThis observational research found that OOB occurred in 16.8% of observed days, which was lower than the 40% expected \u003csup\u003e11\u003c/sup\u003e, although that estimate considered ICUs beyond just neurosurgery. The median time separating first active in-bed mobility from first out of bed mobilization was 4 days, and no prior expectation had been established for this outcome.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis timing was associated with initial GCS, duration of mechanical ventilation and length of stay, thus indicating that the initial severity of the condition is the main factor to delay out of bed mobilization. Also, there was no significant difference in this timing across diagnostic subgroups, although a slight trend for a longer delay in SAH subjects. Therefore, the out of bed mobility cannot be considered as very early (before 24h), but yet is earlier than the typical onset of vasospasm.\u003c/p\u003e\n\u003cp\u003eRegarding the presence of OOB mobilization along the stay, it is not associated with initial severity, but with a longer ICU stay. Before their discharge, some patients probably don\u0026rsquo;t receive an OOB mobilization even if they are capable of it. This could be explained by a stay that was too short and the mobilization then seen as a burden rather than a priority.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study has some limitations. The included population was smaller than the foreseen required sample size, potentially impacting achieved power of the study.\u003c/p\u003e\n\u003cp\u003eAlso, interpretation of our results should be aware of the selection of the population and exclusion of people who would have had the lowest level of mobility, though underestimating how limited mobility is in neurosurgery ICU patients.\u003c/p\u003e\n\u003cp\u003eReporting other specific considerations for acquired brain injuries patients could have led to a better comprehension of mobility outcomes, such as polytrauma, external ventricular drainage, vasospasm, or cognitive impairments.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTo conclude, in people who regained active mobility in a neurosurgery ICU, 76% received at least one OOB mobilization during their stay and median time between first in bed active mobility and OOB mobility was 4 (2-7) days.\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cul\u003e\n \u003cli\u003eABI: Acquired Brain Injury\u003c/li\u003e\n \u003cli\u003eGCS: Glasgow Coma Scale\u003c/li\u003e\n \u003cli\u003eICU: Intensive Care Unit\u003c/li\u003e\n \u003cli\u003eIMS: ICU Mobility Scale\u003c/li\u003e\n \u003cli\u003eOOB: Out-Of-Bed\u003c/li\u003e\n \u003cli\u003eOR: Odd ratio\u003c/li\u003e\n \u003cli\u003ePICS: Post Intensive Care Syndrome\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Declarations","content":"\u003cp\u003e1)\u0026nbsp; \u0026nbsp;The manuscript was verified to comply with all instructions to authors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e2)\u0026nbsp; \u0026nbsp;Authors contributions:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e- HDN: Conceptualization; Methodology; Investigation; Formal Analysis; Writing Original Draft\u003c/p\u003e\n\u003cp\u003e- AL: Investigation; Writing Original Draft\u003c/p\u003e\n\u003cp\u003e- CC: Investigation; Writing Original Draft\u003c/p\u003e\n\u003cp\u003e- VD: Supervision; Conceptualization; Methodology\u003c/p\u003e\n\u003cp\u003e- AJ: Supervision; Conceptualization; Methodology; Formal Analysis; Writing Original Draft\u003c/p\u003e\n\u003cp\u003e3)\u0026nbsp; \u0026nbsp;All authors reviewed the manuscript\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e4)\u0026nbsp; \u0026nbsp;All authorships have been met and the final manuscript was approved by all authors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e5)\u0026nbsp; \u0026nbsp;The manuscript has not been published elsewhere and is not under consideration by another journal.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e6) This study has been conducted in accordance with the 1964 Helsinki declaration and current French law. It was approved by the research ethic committee \u003cem\u003eComit\u0026eacute; Ethique de Recherche en Anesth\u0026eacute;sie et R\u0026eacute;animation\u003c/em\u003e (CERAR), IRB: 00010254\u0026nbsp;‐\u0026nbsp;2025 \u0026ndash; 035. For this retrospective study, formal consent was not required, and waived by the ethic committee.\u003c/p\u003e\n\u003cp\u003e7)\u0026nbsp; \u0026nbsp;The authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e8)\u0026nbsp; \u0026nbsp;Strobe checklist was used and is included at the end of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e9) \u0026nbsp; This study received funding from the University-Hospital of Bordeaux, France, in order to cover the article processing charges for an Open Access submission.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eNeedham DM, Davidson J, Cohen H et al. 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Published online May 1, 2025:101532. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.accpm.2025.101532\u003c/span\u003e\u003cspan address=\"10.1016/j.accpm.2025.101532\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSTROBE, Statement.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7272814/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7272814/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe objective of this observational study was to describe the usual practices of mobilization in a neurosurgical ICU during a specific period, through daily mobility level of patients.\u003c/p\u003e\n\u003cp\u003eThis retrospective cohort study was conducted in a single ICU, where data from a six-month period from January to June of 2024 were collected from patients’ medical records. For each day of stay in the ICU, the maximum level of mobility was described using the French version of the ICU Mobility Scale (IMS) \u003csup\u003e10,11\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe primary outcome of the study was the median time between the first day of active mobility in bed, IMS=1, and the first day of Out-Of-Bed mobilization (OOB), considered as IMS\u0026gt;1. Secondary outcomes to describe mobility were frequency of OOB, and maximal IMS reached during the ICU stay. Baseline characteristics were also reported.\u003c/p\u003e\n\u003cp\u003eTo conclude, in people who regained active mobility in a neurosurgery ICU, 76% received at least one OOB mobilization during their stay and median time between first in bed active mobility and OOB mobility was 4 (2-7) days.\u003c/p\u003e","manuscriptTitle":"Level of mobility and time to first out of bed mobilization in a neurosurgery ICU","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-14 07:05:46","doi":"10.21203/rs.3.rs-7272814/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"637ed669-c088-4661-a453-a9a57504b093","owner":[],"postedDate":"August 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-09T19:37:53+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-14 07:05:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7272814","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7272814","identity":"rs-7272814","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}