Benefits of Early Ambulation in Elderly Patients Undergoing Lumbar Decompression and Fusion Surgery: A Prospective Cohort Study

Huang, Jie; Shi, Zhan; Duan, Fangfang; Fan, Mingxing; Yan, Shuo; Yi, Wei; Han, Bing; Lu, Xuemei; Tian, Wei

doi:10.1111/os.12953

Cited by 24 publications

(20 citation statements)

References 30 publications

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“…4 Similarly, Hueng et al demonstrated that elderly patients who ambulated within 4 hours after lumbar decompression and fusion had lower rates of postoperative ileus and urinary retention compared with those who were able to ambulate between 4 and 24 hours. 5 Adogwa et al described lower incidence of pneumonia and overall postoperative complications among elderly ASD patients who ambulated early on during their postoperative course. 8 Several studies have expanded upon the effect of postoperative mobility by examining patient-reported outcomes and quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have demonstrated the effect of ambulation in the first week after spine surgery on long-term patient disability, physical function, and postoperative complications; however, the relationship between inpatient physical activity after ASD surgery and postoperative complications in elderly patients has not been fully explored. [3][4][5][6][7][8][9][10][11][12][13][14] The ability of the elderly patient to independently walk as early as possible following ASD surgery may decrease the perioperative complication rate. The present study examines the correlation in clinical outcomes of elderly patients with their ability to ambulate.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Inpatient Step Count on Complications in the Elderly Patient After Adult Spinal Deformity Surgery

et al. 2023

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Background: The number of elderly patients undergoing adult spinal deformity (ASD) surgery has increased with the advent of new techniques and more nuanced understanding of global malalignment as patients age. The relationship between inpatient physical activity after ASD surgery and postoperative complications in elderly patients has not been reported; thus, we sought to investigate this relationship.Methods: We performed a medical record review of 185 ASD patients older than 65 years (age: 71.5 ± 4.7; body mass index: 30.0 ± 6.1, American Society of Anesthesiologists: 2.7 ± 0.5, and levels fused: 10.5 ± 3.4). We derived the number of feet walked over the first 3 days after surgery from physical therapy documentation and evaluated for association with 90-day perioperative complications. Patients who sustained an incidental durotomy were excluded from the study.Results: The 185 patients were divided into groups based on whether they were among the 50th percentile for number of feet walked (62 ft). Walking less than 62 ft after ASD surgery was associated with higher incidence of postoperative complications (54.3%, P = 0.05), cardiac complications (34.8%, P = 0.03), pulmonary complications (21.7%, P = 0.01), and ileus (15.2%, P = 0.03). Patients who developed any postoperative complication (106 ± 172 vs 211 ± 279 ft, P = 0.001), ileus (26 ± 49 vs 174 ± 248 ft, P = 0.001), deep venous thrombosis (23 ± 30 vs 171 ± 247 ft, P = 0.001), and cardiac complications (58 ± 94 vs 192 ± 261 ft) walked less than patients who did not.Conclusion: Elderly patients who walked less than 62 ft in the first 3 days after ASD surgery have a higher rate of postoperative complications, specifically pulmonary and ileus compared with those patients who walked more. Steps walked after ASD surgery may be a helpful and practical addition to the surgeon's armamentarium for monitoring the recovery of their patients.Clinical Relevence: Monitoring the steps walked by patients after ASD surgery can be a practical and useful tool for surgeons to track and improve their patients' recovery.Level of Evidence: 3.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Inpatient Step Count on Complications in the Elderly Patient After Adult Spinal Deformity Surgery

et al. 2023

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“…Traditional fasting for 8 h before surgery and eating for 1 day after surgery may lead to insulin resistance and metabolic stress, and metabolic stress may also increase the incidence of postoperative complications [22,23]. In ERAS concept, early ambulation is an important item, which can reduce the incidence of deep vein thrombosis, promote exhaust, shorten the LHS, and reduce the mortality [24,25]. Shortening fasting and early postoperative feeding can improve the metabolic status of patients, enhance resistance, and help patients recover their appetite and shorten the LHS [26].…”

Section: Discussionmentioning

confidence: 99%

A new nursing pattern based on ERAS concept for patients with lumbar degenerative diseases treated with OLIF surgery: A retrospective study

Yang

et al. 2022

Preprint

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Objective The purpose of this study was to introduce enhanced recovery after surgery (ERAS) concept into patients with lumbar degenerative diseases who were treated with oblique lumbar interbody fusion (OLIF), and to assess whether it could increase clinical efficacy, reduce perioperative complications, shorten length of hospital stay (LHS), decrease readmission rate, and improve patient satisfaction. Methods The study included patients with lumbar degenerative diseases (LDDs) who underwent OLIF between July 2017 and October 2018 (non-ERAS group), and between November 2018 and July 2020 (ERAS group) at the Spine Surgery Department of the Third Hospital of Hebei Medical University. The two groups were compared according to the demographic and clinical characteristics. Results There was no significant difference in descriptive characteristics and concomitant diseases between the two groups. The preoperative Oswestry disability index (ODI) score (P = 0.191), lumbar visual analogue scale (VAS) score (P = 0.470), and leg VAS score (P = 0.657) did not significantly different. Most of the ERAS measures were also well implemented after surgery, except for early delivery (74.2%), early catheter removal (63.9%), and multimodal analgesia (80.6%). The LHS in the ERAS group was significantly shorter than that in the non-ERAS group (P = 0.004). Besides, Hamilton Anxiety Rating Scale (HAMA) score at 3 days after surgery showed a significant difference between the two groups (P = 0.019). The patient satisfaction in ERAS group was significantly higher than that in the non-ERAS group (P = 0.001). Conclusion The new nursing pattern combined with ERAS in patients with LDDs who underwent OLIF did not improve the short-term prognosis of surgery, while it could effectively reduce postoperative complications, shorten the LHS, and improve patient satisfaction, and did not lead to additional adverse events.

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“…The outcome variable (continuous variable) was obtained following the previously published guidelines and studies ( 1 , 4 , 5 , 15 , 16 ). In addition, the time to first ambulation was measured as follows: a registration form for the time to first mobilization was distributed upon admission to the hospital and the patient would walk for at least 15 min after getting out of bed for the first time ( 3 , 17 ).…”

Section: Methodsmentioning

confidence: 99%

“…However, there is no standard definition of the time to first ambulation. Previous studies reported that the time to early ambulation may range from 4 h after surgery to 6 h post operation ( 2 – 4 ). Although these studies pointed out the the time horizon to early ambulation, they did not define occurrence of mobilization events ( 1 , 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Take-Home Video Shortens the Time to First Ambulation in Patients With Inguinal Hernia Repair Under General Anesthesia: A Retrospective Observational Study

Jiang

et al. 2022

Front. Med.

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BackgroundData on the relationship between take-home video and the time to first ambulation remains scant. Here, we aimed to investigate whether viewed take-home video during pre-hospitalization is independently associated with the time to first ambulation in postoperative patients with inguinal hernia repair under general anesthesia.MethodsWe retrospectively reviewed and analyzed the relationship between viewed take-home video and the time to first ambulation between September 2020 and October 2021.The independent t-tests or Mann-Whitney U-tests was used to compare the means of two groups (viewed take-home video and non-viewed take-home video). Chi-square test was used to compare the rates between the two groups. We used a linear regression model to see if there was a difference between exposure and outcome variable. Both models were used to observe the effect size of the exposed variable. Subgroup analysis was employed to assess the impact of various factors.ResultsThis study included a total of 120 patients with inguinal hernia repair under general anesthesia following day surgery. The average age of the participants in the two groups was 43.16 and 44.83 years, respectively, and about 82.5% of the patients were male. Our fully adjusted linear regression results showed that individuals in the viewed video group were associated with a decreased time to first ambulation (h) after adjusting for confounders (β = −0.50, 95%CI: −0.83, −0.17; P = 0.004). In addition, the linear regression analysis of the relationship between viewed video and length of stay showed that β = −2.10 (95%CI:CI: −3.85, −0.34; P = 0.021). Similarly, subgroup analysis yielded similar results for the viewed video group patients compared to those in the non-viewed video group.ConclusionTaken together, our findings demonstrated that viewed video could shorten the time to first ambulation, which in turn reduce the length of stay in postoperative patients under general anesthesia.

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Benefits of Early Ambulation in Elderly Patients Undergoing Lumbar Decompression and Fusion Surgery: A Prospective Cohort Study

Cited by 24 publications

References 30 publications

The Effect of Inpatient Step Count on Complications in the Elderly Patient After Adult Spinal Deformity Surgery

The Effect of Inpatient Step Count on Complications in the Elderly Patient After Adult Spinal Deformity Surgery

A new nursing pattern based on ERAS concept for patients with lumbar degenerative diseases treated with OLIF surgery: A retrospective study

Take-Home Video Shortens the Time to First Ambulation in Patients With Inguinal Hernia Repair Under General Anesthesia: A Retrospective Observational Study

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