학술논문
Outpatient surgery postoperative ambulation and emergency department utilization.
Document Type
Academic Journal
Author
Abbitt D; Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave, C-305, Aurora, CO, 80045, USA. danielle.abbitt@cuanschutz.edu.; Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, CO, USA. danielle.abbitt@cuanschutz.edu.; Choy K; Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave, C-305, Aurora, CO, 80045, USA.; Cotton J; Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave, C-305, Aurora, CO, 80045, USA.; Jones TS; Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave, C-305, Aurora, CO, 80045, USA.; Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, CO, USA.; Robinson TN; Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave, C-305, Aurora, CO, 80045, USA.; Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, CO, USA.; Jones EL; Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave, C-305, Aurora, CO, 80045, USA.; Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, CO, USA.
Source
Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The ability to ambulate is an important indicator for wellness and quality of life. A major health event, such as a surgery, can derail this ability, and return to preoperative walking ability is a marker for recovery. Self-reported walking measurements by patients are subject to bias, thus wearable technology such as activity monitors have risen in popularity. We evaluated postoperative ambulation using an accelerometer in outpatient general surgery procedures with the hypothesis that those patients with less postoperative ambulation were at risk for adverse outcomes.
Methods: A retrospective review of patients undergoing outpatient abdominal surgeries from November 2016 to July 2019 at a Veteran Affairs Medical Center. Patients wore an accelerometer preoperatively and postoperatively to measure their ambulation (steps/day). Outcome measures were 30-day readmissions and Emergency Department (ED) utilization. Postoperative ambulation was defined as daily percentages of their preoperative baseline. Patients without preoperative baseline data, > 3 missing days or any missing days prior to reaching baseline were excluded.
Results: One-hundred-six patients underwent outpatient abdominal surgery. Twenty-two patients were excluded. Patients stratified into adult (18-64 years, 44 patients, 52%) and geriatric (≥ 65 years, 40 patients, 48%) cohorts. Geriatric patients were less likely to meet their preoperative baseline by postoperative day 7, 35% vs 61%, p = 0.016. Adult patients who failed to meet their preoperative baseline in first postoperative week had higher ED utilization; 4 (24%) vs 1 (4%), p = 0.04. Geriatric patients who failed to meet their baseline trended toward increased ED utilization; 5 (19%) vs. 1 (7%), p = 0.31.
Conclusion: Patients aged < 65 who fail to return to their preoperative daily step count within one week of outpatient abdominal surgery are 6× more likely to be seen in the ED. Postoperative ambulation may be able to predict ED utilization and recovery after outpatient surgery.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Methods: A retrospective review of patients undergoing outpatient abdominal surgeries from November 2016 to July 2019 at a Veteran Affairs Medical Center. Patients wore an accelerometer preoperatively and postoperatively to measure their ambulation (steps/day). Outcome measures were 30-day readmissions and Emergency Department (ED) utilization. Postoperative ambulation was defined as daily percentages of their preoperative baseline. Patients without preoperative baseline data, > 3 missing days or any missing days prior to reaching baseline were excluded.
Results: One-hundred-six patients underwent outpatient abdominal surgery. Twenty-two patients were excluded. Patients stratified into adult (18-64 years, 44 patients, 52%) and geriatric (≥ 65 years, 40 patients, 48%) cohorts. Geriatric patients were less likely to meet their preoperative baseline by postoperative day 7, 35% vs 61%, p = 0.016. Adult patients who failed to meet their preoperative baseline in first postoperative week had higher ED utilization; 4 (24%) vs 1 (4%), p = 0.04. Geriatric patients who failed to meet their baseline trended toward increased ED utilization; 5 (19%) vs. 1 (7%), p = 0.31.
Conclusion: Patients aged < 65 who fail to return to their preoperative daily step count within one week of outpatient abdominal surgery are 6× more likely to be seen in the ED. Postoperative ambulation may be able to predict ED utilization and recovery after outpatient surgery.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)