Time to early ambulation and its predictors among admitted patients undergoing abdominal surgery in East Gojjam Zone Public Hospitals, Northwest Ethiopia

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Introduction: Early ambulation has demonstrated numerous benefits in the postoperative period. Despite the recognized advantages of early ambulation, there exists considerable variability in the time taken by patients to initiate ambulatory activities. Thus, this study aimed to assess the time to early ambulation and its predictors among patients undergoing abdominal surgery in East Gojjam Zone Public Hospitals, Northwest Ethiopia. Methods: An institutional-based prospective follow-up study was conducted among 444 patients undergoing abdominal surgery by using systematic sampling. Patients were followed for 24 hours along with chart review and interview. After checking the Cox proportional hazard assumptions and model fitness test, the Cox proportional regression analysis model was conducted by using STATA 17 software. Variables with a P value less than 0.2 in the bivariable analysis were selected as candidates for the multivariable Cox proportional regression. An adjusted hazard ratio with its 95% CI was used to show the strength of association, and a P-value less than 0.05 was used to declare statistical significance. Result: From the total of 444 patients undergoing abdominal surgery and followed for 24 hours, 80.6% (95% CI: 0.77- 0.84) of them were ambulated. The incidence rate of early ambulation was 5.64% per 100 patient-hours of follow-up. The median time to early ambulation was 13 hours. Age (AHR = 0.98; 95%CI: (0.97-0.99)), not having a catheter (AHR- 1.77; 95% CI: (1.37- 2.29)), taking tramadol for pain (AHR- 0.26; 95% CI: (0.15-0.45)), postoperative diastolic blood pressure (AHR - 1.01; 95% CI: (1.00-1.02)), respiratory rate (AHR-0.81; 95% CI: (0.75-0.87)), intraoperative pulse rate(AHR- 0.98, 95% CI: (0.97-0.99)), and intraoperative temperature (AHR- 1.50, 95% CI: (1.11-2.03)) were found to be predictors of early ambulation. Conclusion: The median time to early ambulation was 13 hours. Thus, health care providers, particularly nurses and surgeons, should actively promote and facilitate early ambulation within 13 hours following abdominal surgery. Increased age, not having a catheter, taking tramadol for pain, postoperative diastolic blood pressure and respiratory rate, and intraoperative pulse rate and temperature were predictors of time to early ambulation. As a result, it is better to use antipains other than tramadol in addition to encouraging early ambulation among aged patients.

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