Obesity is a known risk factor for postoperative venous thromboembolism (VTE). Early ambulation after bariatric surgery is an effective and common practice for VTE prophylaxis. While early postoperative ambulation has become a standard of care, rarely is it objectively measured despite readily available pedometers. Objective measurements are needed to study the effects of age, gender, and body mass index(BMI) on postoperative ambulation effort.
Using a pedometer the distance ambulated on postoperative day one was recorded for 131 patients undergoing either laparoscopic Roux-en-Y gastric bypass surgery or sleeve gastrectomy. Descriptive statistics were used to summarize distance ambulated, and multivariate regression models were conducted to examine the effect of age, gender, and BMI on distance ambulated.
The mean age of subjects was 43.3 ±11.3years (range: 18 to 69), 80.7%female. The mean BMI was 46.5 ±6.15kg/m2 with a range of 35.1 to 65.4kg/m2. The average patient ambulation on postoperative day one was 1,978 ±1,611 steps for an average distance of 0.87 ±0.71miles and an energy expenditure of 1770 ±180 calories. The multivariate regression models revealed that age is significantly associated with distance ambulated. Increasing age is negatively associated with objectively recorded postoperative day one miles walked (coefficient=-0.012, p=0.03) and feet walked (coefficient=-63.64, p=0.03), but gender and BMI did not show any significant effect on distance ambulated.
Increasing age correlates to reduced ambulation on postoperative day one after bariatric surgery. Older patients may benefit from increased VTE pharmacological prophylaxis to offset reduced ambulation effort in the early postoperative period.