Authors (including presenting author) :
Chan WY(1), Tam KL(1), Cheung TK(1), Cheung KY(1), Wong SW(1), Szeto YL(1), Tsang HC(1), To YL(1), Luk WY(2), 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 emergency abdominal surgery, conventional physiotherapy service usually starts post-operatively, focusing on chest physiotherapy mainly. To enhance recovery and prevent post-operative complications including pneumonia and venous thromboembolism, a new physiotherapy service model was implemented in North District Hospital since October 2019. Early and intensive physiotherapy services are introduced to patients receiving emergency abdominal surgery in NDH. Under the new service model, physiotherapists with more than 5 years’ experience would screen for patients received emergency abdominal surgery through the Operation Theatre Management System (OTMS) on weekdays. A list of criteria for risk stratification is used to identify patients with higher risk of complications. Immediate chest physiotherapy would be provided on post-operation day 0. Chest physiotherapy service would be provided twice daily on post-operation day 1 and 2 with early out of bed mobilization as patient tolerated. Apart from conventional holiday chest physiotherapy, additional out of bed mobilization service would be provided to indicated patients.
Objectives :
To enhance the recovery of patients undergoing emergency abdominal surgery by providing early and intensive physiotherapy intervention.
Methodology :
All patients undergoing emergency abdominal surgery in North District Hospital were recruited into the perioperative physiotherapy program. Demographics and clinical outcomes of patients recruited into the program from October 2019 to May 2021 were retrieved and analyzed.
Result & Outcome :
From October 2019 to May 2021, 502 (60.0% male, 40.0% female) patients with emergency abdominal surgery done were recruited into the perioperative physiotherapy program. The mean age of the patients was 61 years old. Post-operative pneumonia was reported in 8 patients (1.6%) while venous thromboembolism was reported in 3 patients (0.6%). A total of 106 sessions of immediate post-operative chest physiotherapy was provided on day 0 and 522 sessions of extra chest physiotherapy intervention were provided. 52.6% of the cases started out of bed mobilization on post-operation day 1 and 79.7% of cases had mobilized out of bed on the first two days following operation. No adverse effect was reported. Conclusion Early and intensive post-operative physiotherapy intervention is safe and effective for patients undergoing emergency abdominal surgeries, with an aim to reduce post-operative complication.
