Purpose: After abdominal surgery, ambulatory status is an important indicator of postoperative recovery. This study investigated the inability to ambulate on postoperative day 1 and identified associated predictive factors in patients undergoing abdominal surgery, focusing on preoperative hematologic markers such as the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index.
Methods: Adult patients undergoing abdominal surgery from May 2018 to October 2018 were investigated consecutively. Only patients with duration of surgery ≥ 3 h were included for observation. Data on patient characteristics were collected from medical charts and laboratory results. Univariate analysis and multivariate logistic regression were used to determine associations with inability to ambulate without human assistance on postoperative day 1 and postoperative length of stay.
Results: Of 416 eligible patients, 217 patients were included in the analysis. Sixty-nine patients (31.7%) were not able to ambulate on postoperative day 1. The NLR (odds ratio, 1.11; 95% confidence interval, 1.01-1.23), duration of surgery (odds ratio per 1 h, 1.27; 95% confidence interval, 1.06-1.43), and American Society of Anesthesiologists physical status of 3 (odds ratio, 4.99; 95% confidence interval, 1.15-21.5) were independently associated with the inability to ambulate without assistance on postoperative day 1, which was also associated with longer hospital stays (13 [11, 22] vs 21 [15, 39] days, P < 0.001).
Conclusions: The NLR, surgical duration, and American Society of Anesthesiologists physical status were significantly associated with the inability to ambulate without human assistance on postoperative day 1 and prolonged hospitalization.
Keywords: Abdomen; Biomarkers; Early ambulation; Operative time.