Early ambulation after general and digestive surgery: a retrospective single-center study

Area of Science:

• Digestive Surgery
• Postoperative Care
• Patient Outcomes

Background:

• Postoperative early ambulation is linked to better outcomes.
• The precise definition of "early" ambulation remains undefined.
• Identifying optimal timing and risk factors for ambulation is crucial.

Purpose of the Study:

• To define desirable early ambulation timing after digestive surgery.
• To correlate ambulation timing with short-term postoperative outcomes.
• To identify risk factors associated with delayed ambulation.

Main Methods:

• Retrospective analysis of 718 patients undergoing major digestive surgery.
• Correlation of first ambulation timing (postoperative day) with outcomes.
• Multivariate analysis to identify predictors of delayed ambulation.

Main Results:

• 55% ambulated on postoperative day 1, 31% on day 2.
• Ambulation on postoperative day 3 or later was linked to increased infections, longer hospitalization, and lower home discharge rates.
• Poor Eastern Cooperative Oncology Group performance status (ECOG-PS), low controlling nutritional status (CONUT), nonlaparoscopic surgery, and opioid use predicted delayed ambulation.

Conclusions:

• First ambulation before postoperative day 2 is desirable for improved short-term outcomes.
• Preoperative interventions like nutritional care and prehabilitation are recommended for high-risk patients.
• A combination of ECOG-PS, CONUT, and surgical approach stratified patients into risk groups for delayed ambulation.