Delayed ambulation in adult patients after major abdominal surgery in Northwest Ethiopia: a multicenter prospective follow up study.

Abdominal surgery is associated with prolonged hospitalization, reduced physical activity levels, and prolonged bed rest. Delayed ambulation is a major problem after abdominal surgery which result in prolonged hospital stay. Ambulation was defined as delayed if the patient could not walk more than 10 m without assistance on postoperative day one within 24 h of surgery. Although abdominal surgery is performed for a variety of surgical procedures in a day to day practice the incidence and factors associated with delayed ambulation after major abdominal surgery have not been well investigated in the study area. Therefore, the aim of this study was to assess the incidence and factors associated with delayed ambulation after major abdominal surgery. A multicenter, prospective follow up study was conducted from March 28, to June 5, 2023, on 422 participants. Patients were taken consecutively, and data were collected by using a semi-structured questionnaire. Data were entered into Epi Data version 4.6 Software and exported to SPSS version 26 for analysis. Both descriptive and analytic statistics were used. Both bivariable and multivariable logistic regression were used. Variables with a p-value less than < 0.2 in the bivariable analysis were fitted into the multivariable analysis. Both the crude odds' ratio (COR) and Adjusted Odds Ratio (AOR) with 95% Confidence Interval were calculated to show the strength of association. Variables with a p-value of < 0.05 were considered as statistically significant. The overall incidence of delayed ambulation after major abdominal surgery was 48.1% (95%CI:43.4-52.6). Having severe pain (AOR:3.23, 95%CI:1.09-9.55), dizziness (AOR:7.21, 95%CI:3.49-14.91), nasogastric tube (AOR:2.36, 95%CI:1.05-5.34), drain (AOR:3.27, 95%CI:1.52-7.04), fatigue (AOR:7.62, 95%CI:3.71-15.66), intraoperative fluid used > 2000 ml (AOR:2.54, 95%CI:1.03-6.24), duration of surgery > 2-hour (AOR:3.96, 95%CI:1.87-8.38) and blood loss > 500 ml (AOR:2.68, 95%CI:1.24-5.79) were significantly associated with delayed ambulation. Nearly half of the patients were unable to ambulate at postoperative day one after major abdominal surgery. Adopting a zero fluid balance approach, minimizing surgical duration and blood loss, timely removal of drains and catheters, and prioritizing postoperative pain management is recommended.