ABSTRACT
Introducción Se desconoce la importancia del acceso temprano a la fisioterapia (FT) en personas sometidas a cirugía abdominal de urgencia, por lo tanto este estudio se enfocó en determinar la efectividad de la FT temprana versus tardía en la mejora de niveles funcionales y reducción de complicaciones postoperatorias (CP) en adultos sometidos a este procedimiento. Metodología Estudio retrospectivo que incluyó a 132 pacientes ingresados por cirugía abdominal de urgencia. Se registró el inicio de FT (temprana vs. tardía), se evaluó la funcionalidad mediante índice de Barthel y la puntuación acumulada de deambulación (CAS), las CP y la duración de la estancia hospitalaria. Resultados Las personas que recibieron FT temprana exhibieron CP de menor gravedad (p=0,012). Asimismo, el grupo con FT temprana tuvo estancias hospitalarias más cortas (mediana=10 vs. 17 días; p=0,0001). Adicionalmente, se observó que la funcionalidad intrahospitalaria disminuyó respecto a valores prehospitalarios (índice de Barthel y CAS), mientras que al alta se observaron incrementos parciales, sin diferencias entre los grupos que recibieron FT temprana o tardía. Sin embargo, el grupo con FT temprana requirió un menor número de sesiones de FT motora (p=0,04). Conclusión En el presente estudio el desarrollo de CP de menor gravedad, menores estancias hospitalarias y una menor necesidad de FT motora fue observada en pacientes sometidos a cirugía abdominal de urgencia que recibieron FT temprana respecto a tardía. Esto sugiere que la FT temprana en este contexto optimizaría los recursos asociados a la atención en salud, mejorando además el proceso posquirúrgico en estos pacientes (AU)
Introduction Given that the relevancy of early physiotherapy (PT) in persons undergoing emergency abdominal surgery is unknown, this study aimed to determine the effectiveness of early versus late physiotherapy in improving functional levels and reducing postoperative complications (PC) in adults undergoing this procedure. Methodology Longitudinal retrospective study which included a sample of 132 patients admitted for emergency abdominal surgery. Functionality was evaluated using the Barthel index and the cumulated ambulation score (CAS). In addition, the type of PT (early vs. late) and the date of its onset were recorded, the PC during the hospital stay and the length of stay were recorded. Results Patients that received early PT exhibited less severe postoperative complications (p=0.012). Moreover, this group had a shorter length of stay (median=10 vs. 17 days; p=0.0001). In addition, in terms of functionality, decreases were observed during hospitalization compared with baseline levels (Barthel index and CAS), whereas a partial increase was observed at discharge, without differences between the patients that received early PT or not. Nevertheless, the early PT group required a lower number of PT sessions (p=0.04). Conclusion In this study, a less severe postoperative complications rate, shorter length of stay, and lower necessity of PT sessions were observed in adults undergoing emergency abdominal surgery that received early PT versus late PT. This suggests that early PT in this context would optimize health care resources, improving the postoperative process in these patients (AU)
Subject(s)
Humans , Physical Therapy Modalities , Postoperative Complications/rehabilitation , Emergency Service, Hospital , Gastrointestinal Diseases/surgery , Abdomen/surgery , Severity of Illness Index , Physical Functional Performance , Retrospective Studies , Longitudinal StudiesABSTRACT
Objetivo Evaluar la asociación entre la estancia hospitalaria, funcionalidad alcanzada y el tiempo hasta el inicio del tratamiento fisioterapéutico en los pacientes admitidos a un servicio de cirugía de un hospital de alta complejidad. Materiales y métodos Estudio observacional, analítico de corte transversal. Se incluyeron 279 personas (124 mujeres). Los días de retraso en el inicio de fisioterapia, los días cama, la estancia hospitalaria prolongada (percentil 75 de días cama), y el nivel funcional fueron registrados para investigar la influencia del retraso en el inicio de atención fisioterapéutica sobre estas variables. Resultados El número de días de retraso de atención fisioterapéutica estuvo altamente relacionado con el número de días cama (r2 = 0,74, p < 0,05). A su vez, un retraso mayor a cinco días en el inicio de atención fisioterapéutica se asocia al desarrollo de estancias hospitalarias prolongadas (p < 0,05). Sin embargo, la fisioterapia tuvo efectos similares sobre el nivel funcional, aun con retraso en su inicio (p > 0,05). Conclusiones Retrasos en el inicio de atención fisioterapéutica se asociaron con estancias hospitalarias prolongadas en pacientes admitidos a un servicio de cirugía de un hospital de alta complejidad. Futuros estudios deberían investigar los factores asociados a este fenómeno (AU)
Objective To evaluate the association between hospital stay, functional status and physical therapy delay (PT delay) in patients admitted to a surgery unit of a high complexity hospital. Materials and methods Observational, analytic and cross-sectional study. We included 279 patients (124 women). Days of PT delay (calculated as the difference between hospital admission and start of PT), days of bed rest, prolonged hospital stay (75th percentile of bed rest days), and functional status were registered to investigate the influence of PT delay on these variables. Results The number of days of PT delay was strongly associated with the number of bed rest days (r2 = 0.74, p < 0.05). Moreover, a PT delay of five days or more was associated with extended lengths of stay in our sample (p < 0.05). However, physical therapy had similar effects on functional status, even when there were PT delays (p > 0.05). Conclusions PT delay is associated with extended length of stay in patients admitted to a surgery unit of a high complexity hospital. Future studies should investigate the associated factors that could explain the occurrence of PT delays in surgical patients (AU)
Subject(s)
Male , Female , Middle Aged , Aged , Length of Stay , Physical Therapy Modalities , Cross-Sectional Studies , Time Factors , HospitalizationABSTRACT
OBJECTIVE: To evaluate the association between hospital stay, functional status and physical therapy delay (PT delay) in patients admitted to a surgery unit of a high complexity hospital. MATERIALS AND METHODS: Observational, analytic and cross-sectional study. We included 279 patients (124 women). Days of PT delay (calculated as the difference between hospital admission and start of PT), days of bed rest, prolonged hospital stay (75th percentile of bed rest days), and functional status were registered to investigate the influence of PT delay on these variables. RESULTS: The number of days of PT delay was strongly associated with the number of bed rest days (r2 = 0.74, p < 0.05). Moreover, a PT delay of five days or more was associated with extended lengths of stay in our sample (p < 0.05). However, physical therapy had similar effects on functional status, even when there were PT delays (p > 0.05). CONCLUSIONS: PT delay is associated with extended length of stay in patients admitted to a surgery unit of a high complexity hospital. Future studies should investigate the associated factors that could explain the occurrence of PT delays in surgical patients.
