期刊
INTERNATIONAL JOURNAL OF SURGERY
卷 56, 期 -, 页码 161-166出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.ijsu.2018.06.024
关键词
Colorectal surgery; Mobilisation; Early ambulation; Compliance; Enhanced recovery
类别
Background: Enhanced Recovery After Surgery (ERAS) guidelines advocate early postoperative mobilisation to counteract catabolic changes due to immobilisation and maintain muscle strength. The present study aimed to assess compliance to postoperative mobilisation according to ERAS recommendations. Materials and methods: This is a retrospective cohort study on consecutive colorectal surgical procedures treated within an established ERAS protocol within a single center between May 2011 and May 2017. Demographics, surgical details, ERAS related items and surgical outcome were prospectively assessed in a dedicated database and compared between ambulant patients (at least 6 h out of bed at postoperative day (POD) 1) vs. patients not meeting the target (delayed mobilisation). Risk factors for decreased postoperative mobilisation were identified through multivariable logistic regression. Results: 1170 patients were retained. 676 patients (58%) did not mobilise as recommended by ERAS protocol at POD1. Emergency operation (Odds Ratio (OR) 0.40; 95% Confidence Interval (CI) 0.18-0.91, p = 0.028), age > 70 years (OR 0.69; 95% CI 0.47-1.00, p = 0.050) and intraoperative total fluids > 2000 mL (OR 0.59; 95% CI 0.37-0.93, p = 0.025) were independent risk factors for delayed mobilisation. Patients with delayed mobilisation had significantly more overall (Clavien grade I-V) (55% vs. 29%, p = < 0.001), major (Clavien grade IIIb-V) (16% vs. 7%, p = < 0.001) and respiratory (12% vs. 4%, p = < 0.001) complications, as well as longer length of stay (12 +/- 14 vs. 6 +/- 7days, p= < 0.001). Conclusions: More than half of patients did not mobilise as recommended by ERAS guidelines. Emergency surgery, advanced age and fluid overload were independent risk factors for delayed mobilisation, which was associated with increased postoperative complications.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据