PT  - JOURNAL ARTICLE
AU  - Line Rokkedal Jønsson
AU  - Nicolai Bang Foss
AU  - Janne Orbæk
AU  - Morten Laksafoss Lauritsen
AU  - Helene Nygaard Sejrsen
AU  - Morten Tange Kristensen
TI  - Early intensive mobilization after acute high-risk abdominal surgery: a nonrandomized prospective feasibility trial
AID  - 10.1503/cjs.008722
DP  - 2023 May 02
TA  - Canadian Journal of Surgery
PG  - E236--E245
VI  - 66
IP  - 3
4099  - http://canjsurg.ca/content/66/3/E236.short
4100  - http://canjsurg.ca/content/66/3/E236.full
SO  - CAN J SURG2023 May 02; 66
AB  - Background: Mobilization after emergency abdominal surgery is considered essential to facilitate rehabilitation and reduce postoperative complications. The aim of this study was to evaluate the feasibility of early intensive mobilization after acute high-risk abdominal (AHA) surgery.Methods: We conducted a nonrandomized, prospective feasibility trial of consecutive patients after AHA surgery at a university hospital in Denmark. The participants followed a predefined, interdisciplinary protocol for early intensive mobilization during the first 7 postoperative days (PODs) of their hospital admission. We evaluated feasibility in accordance with the percentage of patients who mobilized within 24 hours after surgery, mobilized at least 4 times per day and achieved daily goals of time out of bed and walking distance.Results: We included 48 patients with a mean age of 61 (standard deviation 17) years (48% female). Within 24 hours after surgery, 92% of the patients were mobilized and 82% or more were mobilized at least 4 times per day over the first 7 PODs. On PODs 1–3, 70%–89% of the participants achieved the daily goals of mobilization; participants still in hospital after POD 3 were less able to achieve the daily goals. Patient reported that the primary factors limiting their level of mobilization were fatigue, pain and dizziness. Participants not mobilized independently on POD 3 (28%) had significantly (p ≤ 0.04) fewer hours out of bed (4 v. 8 h), were less able to achieve the goals of time out of bed (45% v. 95%) and walking distance (62% v. 94%) and had longer hospital stays (14 v. 6 d) than participants mobilized independently on POD 3.Conclusion: The early intensive mobilization protocol seems feasible for most patients after AHA surgery. For nonindependent patients, however, alternative mobilization strategies and goals should be investigated.