{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:03:50Z","timestamp":1792177430362,"version":"4.4.0"},"reference-count":20,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:sec id=\"ab-soi230022-4\"><jats:title>Importance<\/jats:title><jats:p>Mobilization after surgery is a key component of Enhanced Recovery after Surgery (ERAS) pathways.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230022-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the association between mobilization and a collapsed composite of postoperative complications in patients recovering from major elective surgery as well as hospital length of stay, cumulative pain scores, and 30-day readmission rates.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230022-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective observational study conducted at a single quaternary US referral center included patients who had elective surgery between February 2017 and October 2020. Mobilization was assessed over the first 48 postoperative hours with wearable accelerometers, and outcomes were assessed throughout hospitalization. Patients who had elective surgery lasting at least 2 hours followed by at least 48 hours of hospitalization were included. A minimum of 12 hours of continuous accelerometer monitoring was required without missing confounding variables or key data. Among 16\u202f203 potential participants, 8653 who met inclusion criteria were included in the final analysis. Data were analyzed from February 2017 to October 2020.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230022-7\"><jats:title>Exposures<\/jats:title><jats:p>Amount of mobilization per hour for 48 postoperative hours.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230022-8\"><jats:title>Outcomes<\/jats:title><jats:p>The primary outcome was a composite of myocardial injury, ileus, stroke, venous thromboembolism, pulmonary complications, and all-cause in-hospital mortality. Secondary outcomes included hospital length of stay, cumulative pain scores, and 30-day readmission.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230022-9\"><jats:title>Results<\/jats:title><jats:p>Of 8653 included patients (mean [SD] age, 57.6 [16.0] years; 4535 [52.4%] female), 633 (7.3%) experienced the primary outcome. Mobilization time was a median (IQR) of 3.9 (1.7-7.8) minutes per monitored hour overall, 3.2 (0.9-7.4) in patients who experienced the primary outcome, and 4.1 (1.8-7.9) in those who did not. There was a significant association between postoperative mobilization and the composite outcome (hazard ratio [HR], 0.75; 95% CI, 0.67-0.84; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) for each 4-minute increase in mobilization. Mobilization was associated with an estimated median reduction in the duration of hospitalization by 0.12 days (95% CI, 0.09-0.15; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) for each 4-minute increase in mobilization. The were no associations between mobilization and pain score or 30-day readmission.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi230022-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this study, mobilization measured by wearable accelerometers was associated with fewer postoperative complications and shorter hospital length of stay.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamasurg.2023.1122","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T15:33:42Z","timestamp":1685547222000},"page":"825","source":"Crossref","is-referenced-by-count":58,"title":["Association Between Mobilization and Composite Postoperative Complications Following Major Elective Surgery"],"prefix":"10.1001","volume":"158","author":[{"given":"Alparslan","family":"Turan","sequence":"first","affiliation":[{"name":"Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio"},{"name":"Department of General Anesthesiology, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish K.","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Section on Critical Care Medicine, Atrium Health Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina"},{"name":"Outcomes Research Consortium, Cleveland, Ohio"},{"name":"Perioperative Outcomes and Informatics Collaborative (POIC), Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Brooker","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit K.","family":"Saha","sequence":"additional","affiliation":[{"name":"Perioperative Outcomes and Informatics Collaborative (POIC), Winston-Salem, North Carolina"},{"name":"Department of Anesthesiology, Atrium Health Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clancy J.","family":"Clark","sequence":"additional","affiliation":[{"name":"Perioperative Outcomes and Informatics Collaborative (POIC), Winston-Salem, North Carolina"},{"name":"Department of Surgery, Atrium Health Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusha","family":"Samant","sequence":"additional","affiliation":[{"name":"Perioperative Outcomes and Informatics Collaborative (POIC), Winston-Salem, North Carolina"},{"name":"Department of Anesthesiology, Atrium Health Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Ozcimen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Ruetzler","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio"},{"name":"Department of General Anesthesiology, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel I.","family":"Sessler","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, Cleveland Clinic, Cleveland, 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