Analysis of associated factors of early mobilization in colorectal cancer patients who underwent enhanced recovery after surgery pathway_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HE Yuhua ,  YANG Jie , JIANG Lili

West China School of Nursing, Sichuan University / Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

YANG Jie, Email: 18980606084@126.com

Keywords：

enhanced recovery after surgery; colorectal cancer; early mobilization

DOI：

10.7507/1007-9424.202106124

Video：

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Objective To investigate the prevalence of early mobilization and it’s influencing factors in colorectal cancer patients who underwent enhanced recovery after surgery (ERAS) pathway. Methods The geneal data and perioperative data were collected through questionnaire survey and accessing to the hospital information system. The situation of early mobilization was investigated by bedside inquiry. Logistic regression was used to analyze the influencing factors of early mobilization in the patients with colorectal cancer. Results In this study, 300 patients with colorectal cancer underwent ERAS were selected. Within 24 h after operation, 47 patients got out of bed, the early mobilization rate was 15.7%. Logistic regression results showed that the patients without preoperative complications (OR=2.726, P=0.019) and without preoperative nutritional risk (OR=3.621, P=0.013), and with operation time <3 h (OR=2.246, P=0.032) increased the probability of early mobilization, and preoperative low albumin decreased the probability of early mobilization (OR=0.364, P=0.007). Conclusions Early mobilization rate of patients with colorectal cancer in ERAS mode is low. Preoperative complications, preoperative albumin level, preoperative NRS2002 score, and operation time were important influencing factors. Active treatment of preoperative complications and improvement of preoperative nutritional status could make patients bear follow-up stress process with better physical condition, which helps to promote early mobilization.

Citation： HE Yuhua, YANG Jie, JIANG Lili. Analysis of associated factors of early mobilization in colorectal cancer patients who underwent enhanced recovery after surgery pathway. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(12): 1599-1603. doi: 10.7507/1007-9424.202106124 Copy

1.	Ripollés-Melchor J, Ramírez-Rodríguez JM, Casans-Francés R, et al. Association between use of enhanced recovery after surgery protocol and postoperative complications in colorectal surgery: the postoperative outcomes within enhanced recovery after surgery protocol (POWER) study. JAMA Surg, 2019, 154(8): 725-736.
2.	Ban KA, Berian JR, Ko CY. Does implementation of enhanced recovery after surgery (ERAS) protocols in colorectal surgery improve patient outcomes? Clin Colon Rectal Surg, 2019, 32(2): 109-113.
3.	P?dziwiatr M, Mavrikis J, Witowski J, et al. Current status of enhanced recovery after surgery (ERAS) protocol in gastrointestinal surgery. Med Oncol, 2018, 35(6): 95.
4.	Castelino T, Fiore JF, Niculiseanu P, et al. The effect of early mobilization protocols on postoperative outcomes following abdominal and thoracic surgery: a systematic review. Surgery, 2016, 159(4): 991-1003.
5.	Yayla A, ?zer N. Effects of early mobilization protocol performed after cardiac surgery on patient care outcomes. Int J Nurs Pract, 2019, 25(6): e12784.
6.	中華醫學會外科學分會, 中華醫學會麻醉學分會. 加速康復外科中國專家共識及路徑管理指南(2018版). 中國實用外科雜志, 2018, 38(1): 1-20.
7.	Chen LK, Woo J, Assantachai P, et al. Asian Working Group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc, 2020, 21(3): 300-307.
8.	Feifel H, Strack S, Nagy VT. Coping strategies and associated features of medically ill patients. Psychosom Med, 1987, 49(6): 616-625.
9.	沈曉紅, 姜乾金. 醫學應對方式問卷中文版701例測試報告. 中國行為醫學科學, 2000, 9(1): 18-20.
10.	周亞光, 楊光田. 營養風險篩查方法簡介(NRS 2002). 內科急危重癥雜志, 2010, 16(2): 106,110.
11.	Christensen T, Bendix T, Kehlet H. Fatigue and cardiorespiratory function following abdominal surgery. Br J Surg, 1982, 69(7): 417-419.
12.	van Zelm R, Coeckelberghs E, Sermeus W, et al. Variation in care for surgical patients with colorectal cancer: protocol adherence in 12 European hospitals. Int J Colorectal Dis, 2017, 32(10): 1471-1478.
13.	Wolk S, Distler M, Müssle B, et al. Adherence to ERAS elements in major visceral surgery—an observational pilot study. Langenbecks Arch Surg, 2016, 401(3): 349-356.
14.	陸云, 宋麗菁, 陳珊. 胃癌術后患者下床活動水平現狀及影響因素分析. 護士進修雜志, 2017, 32(2): 178-180.
15.	Weimann A, Braga M, Carli F, et al. ESPEN guideline: clinical nutrition in surgery. Clin Nutr, 2017, 36(3): 623-650.
16.	Volkert D. Current ESPEN guideline clinical nutrition and hydration in geriatrics. Dtsch Med Wochenschr, 2020, 145(18): 1306-1314.
17.	Bischoff SC, Escher J, Hébuterne X, et al. ESPEN practical guideline: clinical nutrition in inflammatory bowel disease. Clin Nutr, 2020, 39(3): 632-653.
18.	Barbosa AAO, Vicentini AP, Langa FR. Comparison of NRS-2002 criteria with nutritional risk in hospitalized patients. Cien Saude Colet, 2019, 24(9): 3325-3334.
19.	Sanson G, Sadiraj M, Barbin I, et al. Prediction of early- and long-term mortality in adult patients acutely admitted to internal medicine: NRS-2002 and beyond. Clin Nutr, 2020, 39(4): 1092-1100.
20.	Felder S, Lechtenboehmer C, Bally M, et al. Association of nutritional risk and adverse medical outcomes across different medical inpatient populations. Nutrition, 2015, 31(11-12): 1385-1393.
21.	Gillis C, Li C, Lee L, et al. Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology, 2014, 121(5): 937-947.

1. Ripollés-Melchor J, Ramírez-Rodríguez JM, Casans-Francés R, et al. Association between use of enhanced recovery after surgery protocol and postoperative complications in colorectal surgery: the postoperative outcomes within enhanced recovery after surgery protocol (POWER) study. JAMA Surg, 2019, 154(8): 725-736.
2. Ban KA, Berian JR, Ko CY. Does implementation of enhanced recovery after surgery (ERAS) protocols in colorectal surgery improve patient outcomes? Clin Colon Rectal Surg, 2019, 32(2): 109-113.
3. P?dziwiatr M, Mavrikis J, Witowski J, et al. Current status of enhanced recovery after surgery (ERAS) protocol in gastrointestinal surgery. Med Oncol, 2018, 35(6): 95.
4. Castelino T, Fiore JF, Niculiseanu P, et al. The effect of early mobilization protocols on postoperative outcomes following abdominal and thoracic surgery: a systematic review. Surgery, 2016, 159(4): 991-1003.
5. Yayla A, ?zer N. Effects of early mobilization protocol performed after cardiac surgery on patient care outcomes. Int J Nurs Pract, 2019, 25(6): e12784.
6. 中華醫學會外科學分會, 中華醫學會麻醉學分會. 加速康復外科中國專家共識及路徑管理指南(2018版). 中國實用外科雜志, 2018, 38(1): 1-20.
7. Chen LK, Woo J, Assantachai P, et al. Asian Working Group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc, 2020, 21(3): 300-307.
8. Feifel H, Strack S, Nagy VT. Coping strategies and associated features of medically ill patients. Psychosom Med, 1987, 49(6): 616-625.
9. 沈曉紅, 姜乾金. 醫學應對方式問卷中文版701例測試報告. 中國行為醫學科學, 2000, 9(1): 18-20.
10. 周亞光, 楊光田. 營養風險篩查方法簡介(NRS 2002). 內科急危重癥雜志, 2010, 16(2): 106,110.
11. Christensen T, Bendix T, Kehlet H. Fatigue and cardiorespiratory function following abdominal surgery. Br J Surg, 1982, 69(7): 417-419.
12. van Zelm R, Coeckelberghs E, Sermeus W, et al. Variation in care for surgical patients with colorectal cancer: protocol adherence in 12 European hospitals. Int J Colorectal Dis, 2017, 32(10): 1471-1478.
13. Wolk S, Distler M, Müssle B, et al. Adherence to ERAS elements in major visceral surgery—an observational pilot study. Langenbecks Arch Surg, 2016, 401(3): 349-356.
14. 陸云, 宋麗菁, 陳珊. 胃癌術后患者下床活動水平現狀及影響因素分析. 護士進修雜志, 2017, 32(2): 178-180.
15. Weimann A, Braga M, Carli F, et al. ESPEN guideline: clinical nutrition in surgery. Clin Nutr, 2017, 36(3): 623-650.
16. Volkert D. Current ESPEN guideline clinical nutrition and hydration in geriatrics. Dtsch Med Wochenschr, 2020, 145(18): 1306-1314.
17. Bischoff SC, Escher J, Hébuterne X, et al. ESPEN practical guideline: clinical nutrition in inflammatory bowel disease. Clin Nutr, 2020, 39(3): 632-653.
18. Barbosa AAO, Vicentini AP, Langa FR. Comparison of NRS-2002 criteria with nutritional risk in hospitalized patients. Cien Saude Colet, 2019, 24(9): 3325-3334.
19. Sanson G, Sadiraj M, Barbin I, et al. Prediction of early- and long-term mortality in adult patients acutely admitted to internal medicine: NRS-2002 and beyond. Clin Nutr, 2020, 39(4): 1092-1100.
20. Felder S, Lechtenboehmer C, Bally M, et al. Association of nutritional risk and adverse medical outcomes across different medical inpatient populations. Nutrition, 2015, 31(11-12): 1385-1393.
21. Gillis C, Li C, Lee L, et al. Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology, 2014, 121(5): 937-947.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of associated factors of early mobilization in colorectal cancer patients who underwent enhanced recovery after surgery pathway

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