Role of Early Mobilization on the Clinical Course of Patients who Underwent Pancreaticoduodenectomy: A Retrospective Cohort Study

Role of Early Mobilization on the Clinical Course of Patients who Underwent Pancreaticoduodenectomy: A Retrospective Cohort Study

Takuya Fukushima,^1,2 Tomohiko Adachi,³ Masatoshi Hanada,^1,4 Takayuki Tanaka,³ Masato Oikawa,^1,4 Hiroki Nagura,^1,4 Susumu Eguchi³ and Ryo Kozu^1,4

¹Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Nagasaki, Japan
²Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center, Tokyo, Japan
³Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
⁴Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

The length of hospital stay is an important outcome measure in patients who have undergone pancreaticoduodenectomy. Although postoperative complications are known to adversely affect the length of hospital stay (LOS), the influence of early mobilization on LOS has not been clarified yet. This study aimed to examine the impact of the initial ambulation day, which is one of the components of early mobilization, on LOS after pancreaticoduodenectomy. We retrospectively enrolled patients who underwent pancreaticoduodenectomy between January 2013 and December 2017. Postoperative complications were evaluated using the Clavien-Dindo classification (CDC) system. Patients were divided into two groups based on the median LOS (early and late-discharge groups) and compared to determine their characteristics. Multivariate logistic regression analysis was performed with LOS as the dependent variable. Patients in the late-discharge group were significantly older, had an initial ambulation delay, and had higher rates of advanced disease stages and a CDC grade ≥ IIIa than those in the early discharge group. In the multivariate logistic regression analysis, CDC grade ≥ IIIa, initial ambulation day, and age were found to be significant independent factors associated with LOS. Our results demonstrated that not only postoperative complications, but also the initial ambulation day, could affect LOS after pancreaticoduodenectomy, emphasizing the importance of early ambulation for patients who undergo this surgery.

Keywords —— early mobilization; initial ambulation day; length of stay; pancreaticoduodenectomy; postoperative complication

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Tohoku J. Exp. Med., 2021, 254, 283-286

Correspondence: Takuya Fukushima, Ph.D., Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.

e-mail:takuyafukushima321@yahoo.co.jp