RESUMEN
BACKGROUND: Early mobilization after surgery is a cornerstone of the Enhanced Recovery After Surgery (ERAS) programs in total hip arthroplasty (THA) or total knee arthroplasty (TKA). Our goal was to determine the time to mobilization after this surgery and the factors associated with early mobilization. METHODS: This was a predefined substudy of the POWER.2 study, a prospective cohort study conducted in patients undergoing THA and TKA at 131 Spanish hospitals. The primary outcome was the time until mobilization after surgery as well as determining those perioperative factors associated with early mobilization after surgery. RESULTS: A total of 6093 patients were included. The median time to achieve mobilization after the end of the surgery was 24.áhours [16.Çô30]. 4,222 (69.3%) patients moved in .ëñ 24.áhours after surgery. Local anesthesia [OR.á=.á0.80 (95% confidence interval [CI]: 0.72.Çô0.90); p.á=.á0.001], surgery performed in a self-declared ERAS center [OR = 0.57 (95% CI: 0.55.Çô0.60); p.á<.á0.001], mean adherence to ERAS items [OR.á=.á0.93 (95% CI: 0.92.Çô0.93); p.á<.á0.001], and preoperative hemoglobin [OR.á=.á0.97 (95% CI: 0.96.Çô0.98); p.á<.á0.001] were associated with shorter time to mobilization. CONCLUSIONS: Most THA and TKA patients mobilize in the first postoperative day, early time to mobilization was associated with the compliance with ERAS protocols, preoperative hemoglobin, and local anesthesia, and with the absence of a urinary catheter, surgical drains, epidural analgesia, and postoperative complications. The perioperative elements that are associated with early mobilization are mostly modifiable, so there is room for improvement.
Asunto(s)
Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Ambulación Precoz , Humanos , Hemoglobinas , Tiempo de Internación , Complicaciones Posoperatorias/etiología , Estudios ProspectivosRESUMEN
Characteristics and distribution of six plants are described. The chemical composition and in vitro digestibility of leaf and stem of Polymnia maculata, Trigonospermum annuum, Buddleia parviflora Kunt, Canna indica L, Gnaphalium oxyphyllum y Saurauia scabrida Hensl., selected for farmers information, were analysed as a potential resources in animal feeding. The results in dry matter: Crude protein (%): Go and Ss 10.9, Bp 16.7, Pm 11.7 and Ta 11.3. Cell wall (%): Go 54.1, Ss 52.3, Ci 54.4, Bp 68.3, Pm 27.8 and Ta 30.9. Lignin (%): Go and Ss 16.6, Ci 15.5, Bp 10.4, Pm 10.6 and Ta 13.3. IN vitro dry matter digestibility (%): Go 55.1, Ss 37.6, Ci 55.4, Bp 46.5, Pm 82.4 and Ta 81.4. Calcium and phosphorus (mg/100g) respectively: Go 1095 and 379, Ss 1132 and 387, Ci 600 and 421, Bp 800 and 855, Pm 1146 and 421 and Ta 905 and 480. Tannic acid (mg/100g): Go 1450, Ss 1480, Bp 575, Ci 518, Pm 3329 and Ta 2760. Trypsin inhibitor (UIT/g): Go 22264, Ss 29720, Bp 755, Ci 4228, Pm 931 and Ta 4412. Hemagglutinins were detected in Pm and Ta. Alkaloids were detected as scarce in Bp, Ci and Pm, moderate in Ta. Saponins and Cyanogenic glucosides were not detected. It is concluded that Pm and Ta could be considered as a forage for ruminants; Go, Bp and Ci as a complement; recommended the voluntary intake, in vivo digestibility and weight increase trials.