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Amari T, Matta D, Makita Y, Fukuda K, Miyasaka H, Kimura M, Sakamoto Y, Shimo S, Yamaguchi K. Early Ambulation Shortened the Length of Hospital Stay in ICU Patients after Abdominal Surgery. Clin Pract 2023; 13:1612-1623. [PMID: 38131690 PMCID: PMC10742920 DOI: 10.3390/clinpract13060141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/03/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
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.
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Affiliation(s)
- Takashi Amari
- Department of Rehabilitation, Health Science University, 7187 Kodachi, Fujikawaguchiko, Yamanashi 401-0380, Japan; (K.F.); (Y.S.); (S.S.)
- Department of Anatomy and Life Structure, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Daiki Matta
- Department of Rehabilitation, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama 362-8588, Japan; (D.M.); (Y.M.); (H.M.); (M.K.)
| | - Yukiho Makita
- Department of Rehabilitation, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama 362-8588, Japan; (D.M.); (Y.M.); (H.M.); (M.K.)
| | - Kyosuke Fukuda
- Department of Rehabilitation, Health Science University, 7187 Kodachi, Fujikawaguchiko, Yamanashi 401-0380, Japan; (K.F.); (Y.S.); (S.S.)
- Department of Rehabilitation, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama 362-8588, Japan; (D.M.); (Y.M.); (H.M.); (M.K.)
| | - Hiroki Miyasaka
- Department of Rehabilitation, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama 362-8588, Japan; (D.M.); (Y.M.); (H.M.); (M.K.)
| | - Masami Kimura
- Department of Rehabilitation, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama 362-8588, Japan; (D.M.); (Y.M.); (H.M.); (M.K.)
| | - Yuta Sakamoto
- Department of Rehabilitation, Health Science University, 7187 Kodachi, Fujikawaguchiko, Yamanashi 401-0380, Japan; (K.F.); (Y.S.); (S.S.)
- Graduate School of Health and Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo 181-8612, Japan
| | - Satoshi Shimo
- Department of Rehabilitation, Health Science University, 7187 Kodachi, Fujikawaguchiko, Yamanashi 401-0380, Japan; (K.F.); (Y.S.); (S.S.)
| | - Kenichiro Yamaguchi
- Department of Rehabilitation, Sainokuni Higashi Omiya Medical Center, 1522 Toro-cho, Kita-ku, Saitama-shi 331-8577, Japan;
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