PD60-09 QUANTIFICATION OF 5- AND 30-DAY AMBULATION AFTER RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive VI (PD60)1 Apr 2020PD60-09 QUANTIFICATION OF 5- AND 30-DAY AMBULATION AFTER RADICAL CYSTECTOMY Marshall Strother*, Kristen Koepsell, Jennifer Faerber, Lihai Song, Joshua Bernard, Stanley Malkowicz, Thomas Guzzo, and Gregory Tasian Marshall Strother*Marshall Strother* More articles by this author , Kristen KoepsellKristen Koepsell More articles by this author , Jennifer FaerberJennifer Faerber More articles by this author , Lihai SongLihai Song More articles by this author , Joshua BernardJoshua Bernard More articles by this author , Stanley MalkowiczStanley Malkowicz More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , and Gregory TasianGregory Tasian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000977.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Early postoperative ambulation is widely accepted to reduce surgical morbidity. However, the rate of recovery of ambulatory function is unknown in both the immediate postoperative period and following hospital discharge. We measured post-operative ambulation to inform recommendations for physical activity after radical cystectomy. METHODS: We conducted a prospective cohort study of 33 ambulatory adults with ECOG performance status < 2 who underwent radical cystectomy at a single center. Upon enrollment, patients completed validated questionnaires on physical activity, disability, and social support. Fitbits were used to measure step counts over a 3- to 14-day preoperative period and 30-day postoperative period. Postoperative daily step goals were set at 10%, 25%, 40%, and 55% of mean preoperative daily steps on weeks 1 through 4, respectively. All patients received text-based feedback on whether goals were met. Mixed-effects linear regression was used to identify factors associated with daily step counts on postoperative days 1-5 and for the 30-day postoperative period. RESULTS: The median pre-operative average daily step count was 4536 steps (interquartile range 2619, 6171). Median step counts for postoperative days one through five were 42 (0,572), 242 (0,845), 367 (0, 1075), 345 (0,1320), and 575.50 (302, 1860), respectively, as shown in Figure 1. Figure 2 shows the distribution of daily step counts for the entire 30-day postoperative period. ECOG performance status (11/33 patients) was the only preoperative factor significantly associated with postoperative ambulation and was associated with 685 fewer steps per day over the study period in patients with ECOG status 1 vs 0 (95% CI -1370,-0.50 p=0.0498). There was no significant difference between these in the first 5 days (p=0.12). CONCLUSIONS: A step goal of 1000 steps per day is probably achievable and sufficiently challenging for most patients in the first 5 days after surgery. Subsequent recommendations should be tailored to patients’ baseline function. Source of Funding: Institute for Translational Medicine and Therapeutics, National Center for Advancing Translational Science (Grant Number UL1TR000003) © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1277-e1278 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marshall Strother* More articles by this author Kristen Koepsell More articles by this author Jennifer Faerber More articles by this author Lihai Song More articles by this author Joshua Bernard More articles by this author Stanley Malkowicz More articles by this author Thomas Guzzo More articles by this author Gregory Tasian More articles by this author Expand All Advertisement PDF downloadLoading ...