First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study
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 prospe...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/2/e082239.full |
| _version_ | 1797269205247066112 |
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| author | Linda Block Anna Schandl Monika Fagevik Olsen Elisabeth Westerdahl Malin Nygren-Bonnier Maria Sehlin Anna Svensson-Raskh |
| author_facet | Linda Block Anna Schandl Monika Fagevik Olsen Elisabeth Westerdahl Malin Nygren-Bonnier Maria Sehlin Anna Svensson-Raskh |
| author_sort | Linda Block |
| collection | DOAJ |
| description | 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). |
| first_indexed | 2024-03-07T19:12:38Z |
| format | Article |
| id | doaj.art-c3bb6e9dca754005a576d813c847b91c |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-25T01:44:40Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-c3bb6e9dca754005a576d813c847b91c2024-03-07T22:35:08ZengBMJ Publishing GroupBMJ Open2044-60552024-02-0114210.1136/bmjopen-2023-082239First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional studyLinda Block0Anna Schandl1Monika Fagevik Olsen2Elisabeth Westerdahl3Malin Nygren-Bonnier4Maria Sehlin5Anna Svensson-Raskh6Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden/ Department of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Anaesthesiology and Intensive Care, Södersjukhuset, Stockholm, Sweden/ Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, SwedenDepartment of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology and Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, SwedenUniversity Health Care Research Center and Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, SwedenDepartment of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden/ Women`s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, SwedenDepartment of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, SwedenDepartment of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden/ Women`s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, SwedenObjectives 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).https://bmjopen.bmj.com/content/14/2/e082239.full |
| spellingShingle | Linda Block Anna Schandl Monika Fagevik Olsen Elisabeth Westerdahl Malin Nygren-Bonnier Maria Sehlin Anna Svensson-Raskh First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study BMJ Open |
| title | First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study |
| title_full | First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study |
| title_fullStr | First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study |
| title_full_unstemmed | First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study |
| title_short | First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study |
| title_sort | first mobilisation after abdominal and cardiothoracic surgery when is it actually performed a national multicentre cross sectional study |
| url | https://bmjopen.bmj.com/content/14/2/e082239.full |
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