Study links post surgery mobility to favorable outcomes

Medical Xpress / JAMA Surgery ^ | June 2, 2023 | Justin Jackson / Alparslan Turan et al / Martin Almquist et al

[ConservativeMind]

Research evaluated postoperative recovery rates from elective surgery. They found that for patients who underwent major elective surgery, every four minutes of mobilization per monitored hour was inversely associated with postoperative complications and was related to shorter hospitalization times.

Postoperative mortality rates within 30 days are around 1% to 2% and major complications are about ten times more common than deaths. One of the leading approaches to post-surgery recovery is to get the patient mobile with Enhanced Recovery After Surgery (ERAS) protocols designed to promote recovery, expedite healing, and reduce postoperative complications. While these protocols are based on expert opinion, there is little documented evidence that mobilization within ERAS improves postoperative outcomes prompting researchers to take a closer look.

Utilizing retrospective data from multiple health care sites, 8,653 patients who met inclusion criteria were analyzed to see how mobilization related to outcomes. The study looked for complications, hospital length of stay, cumulative pain scores, and 30-day readmission rates.

Mobilization time within the first 48 hours was a median of 3.9 minutes per hour overall. Mobility was lower at 3.2 minutes per hour in patients who died or experienced major complications (myocardial injury, ileus, stroke, venous thromboembolism, or pulmonary complications) compared to the 4.1 minutes per hour in patients who did not.

Increased mobilization ability was associated with decreased complications and reduced hospital stay length. No associations were seen between mobilization and pain scores or 30-day readmission rates.

While the outcomes were more favorable for patients with increased mobility, there is a very real chance that data could be revealing mobility as a risk signal for complications instead of having any direct recovery causation. Another possibility is that the effects of complications, perhaps not yet diagnosed, could already be reducing patient energy and mobility in the first 48 hours.

[ConservativeMind]

It’s an association, but it seems quite likely that moving helps in recovery.

[ConservativeMind]

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[dynachrome]

It worked for me. Back surgery many years ago and gut surgery 15 years ago.

[HDML]

54 seconds per hour difference. I suspect this study is GIGO. Let’s see it replicated as an RCT.

[telescope115]

Within 24 after my transplant surgery, they had me up outta bed. The first day it was just getting up and moving to the chair, and back to bed. Each day it was a little more. It hurt like HELL, but 5 days after surgery, I was home.👍

[Bob434]

i was told to get exercise before surgery to improve outcome too- I think it did help quite a bit-

[MayflowerMadam]

“i was told to get exercise before surgery to improve outcome too- I think it did help quite a bit-”

I had PT for a month prior to hip replacement in 2020, which they said would help. Maybe it did; maybe it didn’t. I only know that my recovery this time was much longer, more painful, with more complications than in the past. (Eight weeks in the past vs six months in 2020.)

I’d had a total hip in 1986 and a revision in 2005. Bounced back quicker than normal, according to both surgeons. No PT before or after.

Also, post-surgery those times I was in the hospital for five days post-surgery.
In 2020, they pushed me out after a day.

Too many variables to say why, definitely.

The surgeries before, follow-up visits were with the surgeons, who had their own practices. This time, I was shuffled among PAs in the massive industrial-like conglomerate.

The surgeries before, no PT. Just my own instinct and determination, and being ultra careful not to do prohibited actions during recovery. This time, PT was involved and I blame the setbacks I had on exercise in PT. Each visit you were shuffled around and “treated” by four or five people. I can’t even call it assembly line, as an assembly line has structure and purpose. From my observation, the only purpose of PT is $$$$$.

Sometimes, the old ways are better. Just be aware of what is prohibited, and push yourself to get to 100%, using what forms of exercise will het you there.

[Bob434]

Well I do know that I was able to walk the hospital walls much easier than if I hadn’t walked prior to surgery. Before walking, I hadn’t been able to walk very far at all without becoming short of breath, and getting weak. I gradually worked up to walking a mile a couple times a week before the surgery-

One of my folks had hip surgery- the person did not do well with the surgery at all, but it had to do with the surgery itself as the hip still isn’t working well- probably gonna have to get it redone. Others fly right through hip surgeries with no problems- with hip and knee surgery, it’s hit or miss I think- some go home soon after and never have problems, others have a hard time. I think it might comedienne to the skill of the surgeon.

Maybe I would have done just as well without pre exercise, but I know I wouldn’t have been able to walk as far if I hadn’t after the surgery. At any rate, I’m glad I forced myself to walk beforehand as it did help with breathing some.