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European Journal of Cardiovascular Nursing
Article . 2023 . Peer-reviewed
License: CC BY NC
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Serveur académique lausannois
Article . 2024
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Early mobilization after transcatheter aortic valve implantation: observational cohort study

Observational cohort study
Authors: Sandra B Lauck; Maggie Yu; Carrie Bancroft; Britt Borregaard; Jopie Polderman; Anna L Stephenson; Eric Durand; +8 Authors

Early mobilization after transcatheter aortic valve implantation: observational cohort study

Abstract

Abstract Aims Early mobilization is associated with improved outcomes in hospitalized older patients. We sought to determine the effect of a nurse-led protocol on mobilization 4 h after transfemoral transcatheter aortic valve implantation (TAVI) across different units of care. Methods and results We conducted a prospective observational cohort single-centre study of consecutive patients. We implemented a standardized protocol for safe early recovery and progressive mobilization in the critical care and cardiac telemetry units. We measured the time to first mobilization and conducted descriptive statistics to identify patient and system barriers to timely ambulation. We recruited 139 patients (82.5 years, SD = 6.7; 46% women). At baseline, patients who were mobilized early (≤4 h) and late (>4 h) did not differ, except for higher rates of diabetes (25.5% vs. 43.9%, P = 0.032) and peripheral arterial disease (8.2% vs. 26.8%, P = 0.003) in the late mobilization group. The median time to mobilization was 4 h [inter-quartile range (IQR) 3.25, 4]; 98 patients (70.5%) were mobilized successfully after 4 h of bedrest; 118 (84.9%) were walking by the evening of the procedure (<8 h bedrest); and 21 (15.1%) were on bedrest overnight and mobilized the following day. Primary reasons for overnight bedrest were arrhythmia monitoring (n = 10, 7.2%) and haemodynamic and/or neurological instability (n = 6, 4.3%); six patients (4.3%) experienced delayed ambulation due to system issues. Procedure location in the hybrid operating room and transfer to critical care were associated with longer bedrest times. Conclusion Standardized nurse-led mobilization 4 h after TF TAVI is feasible in the absence of clinical complications and system barriers.

Keywords

Minimalist approach, Transcatheter Aortic Valve Replacement/methods, Male, Aged, 80 and over, Transcatheter aortic valve implantation, Time Factors, Mobilization, Aortic Valve Stenosis, Cohort Studies, Transcatheter Aortic Valve Replacement, Treatment Outcome, Clinical pathway, Humans; Female; Male; Transcatheter Aortic Valve Replacement/methods; Aortic Valve Stenosis/surgery; Early Ambulation; Treatment Outcome; Time Factors; Cohort Studies; Clinical pathway; Minimalist approach; Mobilization; Transcatheter aortic valve implantation, 80 and over, Humans, Female, Aortic Valve Stenosis/surgery, Prospective Studies, Early Ambulation, Aged

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    influence
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    impulse
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Top 10%
Average
Top 10%
Green
hybrid
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