First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional studyShow others and affiliations
2024 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 14, no 2, article id e082239Article in journal (Refereed) Published
Abstract [en]
OBJECTIVES: Knowledge of clinical practice regarding mobilisation after surgery is lacking. This study therefore aimed to reveal current mobilisation routines after abdominal and cardiothoracic surgery and to identify factors associated with mobilisation within 6 hours postoperatively. DESIGN: A prospective observational national multicentre study.
SETTING: 18 different hospitals in Sweden.
PARTICIPANTS: 1492 adult patients undergoing abdominal and cardiothoracic surgery with duration of anaesthesia>2 hours.
PRIMARY AND SECONDARY OUTCOMES: Primary outcome was time to first postoperative mobilisation. Secondary outcomes were the type and duration of the first mobilisation. Data were analysed using multivariate logistic regression and general structural equation modelling, and data are presented as ORs with 95% CIs.
RESULTS: Among the included patients, 52% were mobilised to at least sitting on the edge of the bed within 6 hours, 70% within 12 hours and 96% within 24 hours. Besides sitting on the edge of the bed, 76% stood up by the bed and 22% were walking away from the bedside the first time they were mobilised. Patients undergoing major upper abdominal surgery required the longest time before mobilisation with an average time of 11 hours post surgery. Factors associated with increased likelihood of mobilisation within 6 hours of surgery were daytime arrival at the postoperative recovery unit (OR: 5.13, 95% CI: 2.16 to 12.18), anaesthesia <4 hours (OR: 1.68, 95% CI: 1.17 to 2.40) and American Society of Anaesthesiologists (ASA) classification 1-2, (OR: 1.63, 95% CI: 1.13 to 2.36).
CONCLUSIONS: In total, 96% if the patients were mobilised within 24 hours after surgery and 52% within 6 hours. Daytime arrival at the postoperative recovery unit, low ASA classification and shorter duration of anaesthesia were associated with a shorter time to mobilisation. TRIAL
REGISTRATION NUMBER: FoU, Forskning och Utveckling in VGR, Vastra Gotaland Region (Id:275357) and Clinical Trials (NCT04729634).
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024. Vol. 14, no 2, article id e082239
Keywords [en]
Cardiothoracic surgery, Colorectal surgery, Pancreatic surgery, Physical Therapy Modalities
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-112084DOI: 10.1136/bmjopen-2023-082239ISI: 001179438900019PubMedID: 38423778Scopus ID: 2-s2.0-85186340417OAI: oai:DiVA.org:oru-112084DiVA, id: diva2:1842276
Funder
Nyckelfonden
Note
This study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (ALFGBG-965563), by The Local Research and Development Council, Gothenburg and Södra Bohuslän (VGFOUGSB-970106) and by Nyckelfonden, Örebro University Hospital Research Foundation (Grant number N/A).
2024-03-042024-03-042024-04-03Bibliographically approved