Authors (including presenting author) :
Tam KL (1), Chan WY (1), Hau CY (1), Chan YT (1), Cheung TKR (1), Tsang HC (1), To YL (1), Ng CK(2), Sun TF(3)
Affiliation :
(1) Physiotherapy Department, North District Hospital (2) Surgery Department, North District Hospital, (3) Hospital Chief Executive Office, North District Hospital
Introduction :
For patients undergoing abdominal surgeries, conventional physiotherapy service mainly focuses on chest physiotherapy while mobilization only starts at later stage. To enhance recovery and prevent post-operative complications including pneumonia and venous thromboembolism, a protocol-driven physiotherapy service model has been implemented in North District Hospital since October 2019.
Under the new service model, patients receiving elective and emergency abdominal surgery are assessed by physiotherapists to rule out contraindication for mobilization. Early post-operative out-of-bed mobilization would be initiated on the first day post-operation if condition stable. Apart from chest physiotherapy, additional out-of-bed mobilization services are provided to indicated patients during weekend and public holidays.
Objectives :
To investigate the relationship of early out-of-bed mobilization and length of stay (LOS) of patients received emergency and elective abdominal surgery.
Methodology :
Data of patients received elective and emergency abdominal surgery in North District Hospital from October 2019 to September 2021 were retrieved. Cases underwent abdominal surgery defined as “Major” and “Ultra-major” were included. The LOS and the time to first out-of-bed mobilization were recorded and analyzed. Pearson’s r was used to investigate the correlations between LOS and time to first out of bed mobilization.
Result & Outcome :
Results:
In the group of elective abdominal surgery, there were 922 patients (61.9% male, 38.1% female) with a mean age of 64.7. The median LOS and time to first mobilization out of bed were 7 days and day 1 post-operation. In the group of emergency abdominal surgery, there were 585 patients (male: 59%, female: 41%) with a mean age of 61.7. The median LOS and time to first mobilization out-of-bed were 10 days and day 1 post-operation.
Significant positive correlation was found between the time to first out-of-bed mobilization after surgery and LOS in both elective (p<0.001) and emergency surgery group (p<0.001). Patients with earlier post-operative out-of-bed mobilization tended to have shorter LOS for both elective and emergency abdominal surgery.
Conclusion:
For both elective and emergency abdominal surgery, patients who mobilized out of bed earlier was associated with shorter LOS in hospital. Early mobilization after abdominal surgery might facilitate patient’s post-operative recovery with shorter hospital LOS.
