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Related Experiment Video

Updated: Jan 5, 2026

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Associated factors with delayed ambulation after abdominal surgery.

Jun Asada1,2, Mitsuru Ida3, Mariko Sato2

  • 1Department of Central Operating Room, Yamatotakada Municipal Hospital, 1-1 Isono-cho kita-machi, Yamatotakada, Nara, 635-8501, Japan.

Journal of Anesthesia
|October 18, 2019
PubMed
Summary

Postoperative day 1 ambulation after abdominal surgery is linked to recovery. The neutrophil-to-lymphocyte ratio (NLR), surgery duration, and ASA physical status predict inability to walk, impacting hospital stay.

Keywords:
AbdomenBiomarkersEarly ambulationOperative time

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Area of Science:

  • Surgical Outcomes Research
  • Patient Recovery Metrics
  • Predictive Biomarkers in Surgery

Background:

  • Ambulatory status on postoperative day 1 is a key indicator of recovery following abdominal surgery.
  • Identifying predictive factors for early ambulation is crucial for optimizing patient care and reducing hospital stays.

Purpose of the Study:

  • To investigate the inability to ambulate on postoperative day 1 after abdominal surgery.
  • To identify preoperative hematologic markers, specifically the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index, as predictive factors.

Main Methods:

  • Adult patients undergoing abdominal surgery (≥3 hours duration) were consecutively enrolled.
  • Data on patient characteristics, laboratory results, and surgical details were collected.
  • Univariate and multivariate logistic regression analyses were performed to identify associations with ambulation status and length of stay.

Main Results:

  • Of 217 eligible patients, 31.7% were unable to ambulate on postoperative day 1.
  • Neutrophil-to-lymphocyte ratio (NLR), longer surgical duration, and American Society of Anesthesiologists (ASA) physical status of 3 were independently associated with inability to ambulate.
  • Inability to ambulate was significantly associated with a prolonged hospital stay (21 vs 13 days).

Conclusions:

  • Preoperative NLR, surgical duration, and ASA physical status are significant predictors of impaired ambulation on postoperative day 1.
  • These factors are also associated with prolonged hospitalization after abdominal surgery.
  • The findings highlight the utility of readily available markers in predicting postoperative recovery trajectories.