Early Ambulation Shortened the Length of Hospital Stay in ICU Patients after Abdominal Surgery

Author:

Amari Takashi12,Matta Daiki3,Makita Yukiho3,Fukuda Kyosuke13,Miyasaka Hiroki3,Kimura Masami3,Sakamoto Yuta14ORCID,Shimo Satoshi1ORCID,Yamaguchi Kenichiro5

Affiliation:

1. Department of Rehabilitation, Health Science University, 7187 Kodachi, Fujikawaguchiko, Yamanashi 401-0380, Japan

2. Department of Anatomy and Life Structure, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan

3. Department of Rehabilitation, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama 362-8588, Japan

4. Graduate School of Health and Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo 181-8612, Japan

5. Department of Rehabilitation, Sainokuni Higashi Omiya Medical Center, 1522 Toro-cho, Kita-ku, Saitama-shi 331-8577, Japan

Abstract

The optimal time to ambulation remains unclear for intensive care unit (ICU) patients following abdominal surgery. While previous studies have explored various mobilization techniques, a direct comparison between ambulation and other early mobilization methods is lacking. Additionally, the impact of time to ambulation on complications and disuse syndrome prevention requires further investigation. This study aimed to identify the optimal time to ambulation for ICU patients after abdominal surgery and considered its potential influence on complications and disuse syndrome. We examined the relationship between time to ambulation and hospital length of stay (LOS). Patients were categorized into the nondelayed (discharge within the protocol time) and delayed (discharge later than expected) groups. Data regarding preoperative functioning, postoperative complications, and time to discharge were retrospectively collected and analyzed. Of the 274 postsurgical patients managed in the ICU at our hospital between 2018 and 2020, 188 were included. Time to ambulation was a significant prognostic factor for both groups, even after adjusting for operative time and complications. The area under the curve was 0.72, and the cutoff value for time to ambulation was 22 h (sensitivity, 68%; specificity, 77%). A correlation between time to ambulation and complications was observed, with both impacting the hospital LOS (model 1: p < 0.01, r = 0.22; model 2: p < 0.01, r = 0.29). Specific cutoff values for time to ambulation will contribute to better surgical protocols.

Funder

Saitama Chapter, Japanese Physical Therapy Association for Study Promotion

University of Health Sciences

Publisher

MDPI AG

Subject

General Medicine

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