First Mobilisation After Abdominal and Cardiothoracic Surgery: when is It Actually Performed? A National, Multicentre, Cross-sectional Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2024 Feb 29

PMID 38423778

Authors

Monika Fagevik Olsen

Maria Sehlin

Elisabeth Westerdahl

Anna Schandl

Linda Block

Malin Nygren-Bonnier

Anna Svensson-Raskh

Affiliations

Soon will be listed here.

Abstract

Objectives: Knowledge of clinical practice regarding mobilisation after surgery is lacking. This study therefore aimed to reveal current mobilisation routines after abdominal and cardiothoracic surgery and to identify factors associated with mobilisation within 6 hours postoperatively.

Design: A prospective observational national multicentre study.

Setting: 18 different hospitals in Sweden.

Participants: 1492 adult patients undergoing abdominal and cardiothoracic surgery with duration of anaesthesia>2 hours.

Primary And Secondary Outcomes: Primary outcome was time to first postoperative mobilisation. Secondary outcomes were the type and duration of the first mobilisation. Data were analysed using multivariate logistic regression and general structural equation modelling, and data are presented as ORs with 95% CIs.

Results: Among the included patients, 52% were mobilised to at least sitting on the edge of the bed within 6 hours, 70% within 12 hours and 96% within 24 hours. Besides sitting on the edge of the bed, 76% stood up by the bed and 22% were walking away from the bedside the first time they were mobilised. Patients undergoing major upper abdominal surgery required the longest time before mobilisation with an average time of 11 hours post surgery. Factors associated with increased likelihood of mobilisation within 6 hours of surgery were daytime arrival at the postoperative recovery unit (OR: 5.13, 95% CI: 2.16 to 12.18), anaesthesia <4 hours (OR: 1.68, 95% CI: 1.17 to 2.40) and American Society of Anaesthesiologists (ASA) classification 1-2, (OR: 1.63, 95% CI: 1.13 to 2.36).

Conclusions: In total, 96% if the patients were mobilised within 24 hours after surgery and 52% within 6 hours. Daytime arrival at the postoperative recovery unit, low ASA classification and shorter duration of anaesthesia were associated with a shorter time to mobilisation.

Trial Registration Number: FoU, Forskning och Utveckling in VGR, Vastra Gotaland Region (Id:275357) and Clinical Trials (NCT04729634).

Citing Articles

First initiation of mobilization out of bed after cardiac surgery - an observational cross-sectional study in Sweden.

Westerdahl E, Lilliecrona J, Sehlin M, Svensson-Raskh A, Nygren-Bonnier M, Fagevik Olsen M J Cardiothorac Surg. 2024; 19(1):420.

PMID: 38961385 PMC: 11223441. DOI: 10.1186/s13019-024-02915-4.

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