目的:尽管ERAS®结直肠指南强烈建议动员,研究表明,超过一半的患者没有达到每天下床360分钟的目标。然而,用于量化动员的数据主要基于自我评估,其准确性是不确定的。本研究旨在通过身体传感器验证的运动数据来准确测量ERAS®患者的术后动员。
方法:ERAS®-选择性肠切除术患者符合资格。自我评估和运动传感器(movisens:ECG-Move4和Move4;Garmin:Vivosmart4)用于记录从手术到术后第3天的动员参数(POD3):下床时间,时间和步数。
结果:对97例患者进行了筛查,纳入60例患者参与研究。自我评估显示,下床时间中位数为215分钟/天(POD1:135分钟,POD2:225分钟,POD3:225分钟)。360分钟的目标在POD1达到16.67%,在POD2达到21.28%,在POD3达到20.45%。通过Move4客观测量的脚上的中位时间为109分钟/天。在自我评估期间,患者明显低估了他们的“站立时间”-85分钟/天(p=0.008)。步数中位数为933/天(移动4)。
结论:这项研究得到了客观支持的数据,尽管通过ERAS®-nurse的ERAS®途径治疗,但大多数患者仍未达到每天360分钟的动员目标。即使考虑到经验上近似的低估,超过75%的患者未实现ERAS®目标。因此,我们建议将一般ERAS®目标调整为更以患者为中心,个性化和可实现的目标。
背景:该研究是MINT-ERAS-项目的一部分,并在25.02.2022的德国临床试验注册中进行了前瞻性注册。试用注册号为“DRKS00027863”。
OBJECTIVE: Despite mobilization is highly recommended in the ERAS® colorectal guideline, studies suggest that more than half of patients don\'t reach the daily goal of 360 min out of bed. However, data used to quantify mobilization are predominantly based on self-assessments, for which the accuracy is uncertain. This study aims to accurately measure postoperative mobilization in ERAS®-patients by validated motion data from body sensors.
METHODS: ERAS®-patients with elective bowel resections were eligible. Self-assessments and motion sensors (movisens: ECG-Move 4 and Move 4; Garmin: Vivosmart4) were used to record mobilization parameter from surgery to postoperative day 3 (POD3): Time out of bed, time on feet and step count.
RESULTS: 97 patients were screened and 60 included for study participation. Self-assessment showed a median out of bed duration of 215 min/day (POD1: 135 min, POD2: 225 min, POD3: 225 min). The goal of 360 min was achieved by 16.67% at POD1, 21.28% at POD2 and 20.45% at POD3. Median time on feet objectively measured by Move 4 was 109 min/day. During self-assessment, patients significantly underestimated their \"time on feet\"-duration with 85 min/day (p = 0.008). Median number of steps was 933/day (Move 4).
CONCLUSIONS: This study confirmed with objectively supported data, that most patients don\'t reach the daily mobilization goal of 360 min despite being treated by an ERAS®-pathway with ERAS®-nurse. Even considering an empirically approximated underestimation, the ERAS®-target isn\'t achieved by more than 75% of patients. Therefore, we propose an adjustment of the general ERAS®-goals into more patient-centered, individualized and achievable goals.
BACKGROUND: This study is part of the MINT-ERAS-project and was registered prospectively in the German Clinical Trials Register on 25.02.2022. Trial registration number is \"DRKS00027863\".