Advertisement
Canadian Journal of Cardiology
Letters to the Editor| Volume 37, ISSUE 8, P1301, August 2021

Reply to Tsuge et al.—Early Mobilization in People With Acute Cardiovascular Disease

Published:April 29, 2021DOI:https://doi.org/10.1016/j.cjca.2021.04.015
      We thank Tsuge and colleagues for their interest in our study and for their contribution to understanding the role of early mobilization in acute cardiac care.
      • Tsuge S
      • Kameda I
      • Ito T
      • et al.
      Barriers and strategies for early mobilization in acute cardiovascular disease.
      The emerging evidence for early mobilization in the acute cardiac setting is promising. However, the current evidence base, including our current study, is mainly observational or retrospective in nature and is thus subject to the corresponding biases.
      • Goldfarb M
      • Afilalo J
      • Chan A
      • Herscovici R
      • Cercek B.
      Early mobility in frail and non-frail older adults admitted to the cardiovascular intensive care unit.
      To address potential biases in our study, we included consecutive admissions to the cardiac intensive care unit, compared consecutive time periods (pre- and postintervention), and adjusted for potential confounders, including admission for heart failure. The intervention group had a higher rate of primary admission for heart failure, which is associated with older age and higher levels of frailty, than the usual mobility care group (15% vs 11%, respectively) yet still had a higher rate of discharge home. Nonetheless, we acknowledge that unmeasured confounders inherent to the study methodology may have affected our results. There remains a strong unmet need for high-quality, multicentre randomized studies to explore whether early mobilization in acute cardiovascular care improves clinical and person-centred outcomes.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Canadian Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Tsuge S
        • Kameda I
        • Ito T
        • et al.
        Barriers and strategies for early mobilization in acute cardiovascular disease.
        Can J Cardiol. 2021; 37: 1300
        • Goldfarb M
        • Afilalo J
        • Chan A
        • Herscovici R
        • Cercek B.
        Early mobility in frail and non-frail older adults admitted to the cardiovascular intensive care unit.
        J Crit Care. 2018; 47: 9-14
        • Hunter OO
        • George EL
        • Ren D
        • Morgan D
        • Rosenzweig M
        • Klinefelter Tuite P
        Overcoming nursing barriers to intensive care unit early mobilisation: a quality improvement project.
        Intens Crit Care Nurs. 2017; 40: 44-50

      Linked Article

      • Barriers and Strategies for Early Mobilization in Acute Cardiovascular Disease
        Canadian Journal of CardiologyVol. 37Issue 8
        • Preview
          We read with great interest the article by Semsar-Kazerooni et al., which discussed the importance of early mobilization in people with acute cardiovascular disease.1 This was a historical cohort study with no major confounding by indication and involved a large sample size. In addition, approximately 90% of the participants were on an early mobilization program, which was feasible, safe, and impressive. We have also reported that early mobilization in patients with acute heart failure reduced the rate of decline in activities of daily living by half the odds ratio.
        • Full-Text
        • PDF
      • Percutaneous Closure of a Giant Aortic Pseudoaneurysm Using Multimodality Imaging Guidance
        Canadian Journal of CardiologyVol. 37Issue 8
        • Preview
          Ascending aortic pseudoaneurysm is a rare, life-threatening complication of cardiac surgery. Surgical management is recommended, however, transcatheter techniques offer a less invasive alternative. We describe successful percutaneous closure, guided by using multimodality imaging, in a patient with high surgical risk.
        • Full-Text
        • PDF