Feasibility and usefulness of postoperative mobilization goals in the enhanced recovery after surgery (ERAS^®) clinical pathway for elective colorectal surgery.

IF 2.1 3区医学 Q2 SURGERY Langenbeck's Archives of Surgery Pub Date : 2024-08-31 DOI:10.1007/s00423-024-03442-5

Rico Wiesenberger, Julian Müller, Mario Kaufmann, Christel Weiß, David Ghezel-Ahmadi, Julia Hardt, Christoph Reissfelder, Florian Herrle

{"title":"Feasibility and usefulness of postoperative mobilization goals in the enhanced recovery after surgery (ERAS®) clinical pathway for elective colorectal surgery.","authors":"Rico Wiesenberger, Julian Müller, Mario Kaufmann, Christel Weiß, David Ghezel-Ahmadi, Julia Hardt, Christoph Reissfelder, Florian Herrle","doi":"10.1007/s00423-024-03442-5","DOIUrl":null,"url":null,"abstract":"Purpose: Despite mobilization is highly recommended in the ERAS® colorectal guideline, studies suggest that more than half of patients don't reach the daily goal of 360 min out of bed. However, data used to quantify mobilization are predominantly based on self-assessments, for which the accuracy is uncertain. This study aims to accurately measure postoperative mobilization in ERAS®-patients by validated motion data from body sensors.Methods: ERAS®-patients with elective bowel resections were eligible. Self-assessments and motion sensors (movisens: ECG-Move 4 and Move 4; Garmin: Vivosmart4) were used to record mobilization parameter from surgery to postoperative day 3 (POD3): Time out of bed, time on feet and step count.Results: 97 patients were screened and 60 included for study participation. Self-assessment showed a median out of bed duration of 215 min/day (POD1: 135 min, POD2: 225 min, POD3: 225 min). The goal of 360 min was achieved by 16.67% at POD1, 21.28% at POD2 and 20.45% at POD3. Median time on feet objectively measured by Move 4 was 109 min/day. During self-assessment, patients significantly underestimated their \"time on feet\"-duration with 85 min/day (p = 0.008). Median number of steps was 933/day (Move 4).Conclusion: This study confirmed with objectively supported data, that most patients don't reach the daily mobilization goal of 360 min despite being treated by an ERAS®-pathway with ERAS®-nurse. Even considering an empirically approximated underestimation, the ERAS®-target isn't achieved by more than 75% of patients. Therefore, we propose an adjustment of the general ERAS®-goals into more patient-centered, individualized and achievable goals.Registration: This study is part of the MINT-ERAS-project and was registered prospectively in the German Clinical Trials Register on 25.02.2022. Trial registration number is \"DRKS00027863\".","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365838/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Langenbeck's Archives of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00423-024-03442-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Despite mobilization is highly recommended in the ERAS^® colorectal guideline, studies suggest that more than half of patients don't reach the daily goal of 360 min out of bed. However, data used to quantify mobilization are predominantly based on self-assessments, for which the accuracy is uncertain. This study aims to accurately measure postoperative mobilization in ERAS^®-patients by validated motion data from body sensors.

Methods: ERAS^®-patients with elective bowel resections were eligible. Self-assessments and motion sensors (movisens: ECG-Move 4 and Move 4; Garmin: Vivosmart4) were used to record mobilization parameter from surgery to postoperative day 3 (POD3): Time out of bed, time on feet and step count.

Results: 97 patients were screened and 60 included for study participation. Self-assessment showed a median out of bed duration of 215 min/day (POD1: 135 min, POD2: 225 min, POD3: 225 min). The goal of 360 min was achieved by 16.67% at POD1, 21.28% at POD2 and 20.45% at POD3. Median time on feet objectively measured by Move 4 was 109 min/day. During self-assessment, patients significantly underestimated their "time on feet"-duration with 85 min/day (p = 0.008). Median number of steps was 933/day (Move 4).

Conclusion: This study confirmed with objectively supported data, that most patients don't reach the daily mobilization goal of 360 min despite being treated by an ERAS^®-pathway with ERAS^®-nurse. Even considering an empirically approximated underestimation, the ERAS^®-target isn't achieved by more than 75% of patients. Therefore, we propose an adjustment of the general ERAS^®-goals into more patient-centered, individualized and achievable goals.

Registration: This study is part of the MINT-ERAS-project and was registered prospectively in the German Clinical Trials Register on 25.02.2022. Trial registration number is "DRKS00027863".

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

在择期结直肠手术的术后强化恢复（ERAS®）临床路径中制定术后活动目标的可行性和实用性。

目的：尽管ERAS®结直肠指南强烈建议进行移动，但研究表明，一半以上的患者达不到每天下床活动360分钟的目标。然而，用于量化活动量的数据主要基于自我评估，其准确性尚不确定。本研究旨在通过身体传感器的有效运动数据，准确测量 ERAS® 患者的术后活动能力：方法：选择性肠切除术的 ERAS® 患者均符合条件。采用自我评估和运动传感器（movisens：ECG-Move 4和Move 4；Garmin：Vivosmart4）记录从手术到术后第3天（POD3）的活动参数：结果：结果：共筛选出 97 名患者，其中 60 人参与研究。自我评估显示，每天下床活动时间的中位数为 215 分钟（POD1：135 分钟，POD2：225 分钟，POD3：225 分钟）。有 16.67% 的人在 POD1、21.28% 的人在 POD2 和 20.45% 的人在 POD3 达到了 360 分钟的目标。根据 "移动 4 "客观测量的中位步行时间为 109 分钟/天。在自我评估中，患者明显低估了自己的 "站立时间"，为 85 分钟/天（p = 0.008）。步数中位数为 933 步/天（Move 4）：这项研究通过客观数据证实，尽管ERAS®路径配备了ERAS®护士，但大多数患者并没有达到每天360分钟的活动目标。即使考虑到经验上的近似低估，75%以上的患者也无法达到ERAS®目标。因此，我们建议将ERAS®的一般目标调整为更加以患者为中心、个性化和可实现的目标：本研究是 MINT-ERAS 项目的一部分，已于 2022 年 2 月 25 日在德国临床试验注册处进行了前瞻性注册。试验注册号为 "DRKS00027863"。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.