DELAYED MOBILIZATION AND LENGTH OF STAY IN ELDERLY SURGICAL PATIENTS: PROSPECTIVE COHORT STUDY
Bibliographic record
Abstract
Surgical admissions are increasing in older and frailer patients, who are vulnerable to post-operative morbidity and mortality. Early post-operative mobilization may reduce adverse events and length of stay (LOS), but little is actually known about the impact of delayed mobility. Therefore, we assessed the independent association of delayed mobilization with LOS in elderly surgical patients. Overall, 306 consecutive survivors of emergent abdominal surgery aged ≥65y who required help with <3 activities of daily living were prospectively enrolled at 2 tertiary-care Canadian hospitals. Time until post-operative mobilization (out of bed) was attained from hospital records and a priori defined as ‘delayed’ (≥36h) or ‘early’ (<36h) and analyzed with multivariable negative binomial regression. Mean age was 76 ± 7.7 years, 45% were women, and 22% were frail according to the Clinical Frailty Scale. Gallstones (23%), intestinal obstructions (21%), and herniae (17%) were the most performed surgeries. Median time to post-operative mobilization was 19h (interquartile range [IQR] 9–35) and median LOS was 9 days (IQR 6–14). One-quarter (n=74) of patients had delayed mobilization, which was associated with much longer median LOS vs early mobilization (14 days [IQR 10–28] vs 7 days [IQR 5–11] p<0.001). After multivariable adjustment, delayed mobilization was still independently associated with longer LOS (adjusted ratio 1.25, 95%CI 1.05–1.44, p=0.03). Additionally, delayed mobilization was associated with greater use of homecare (p=0.1) and discharge to higher levels of care (p=0.02). Potentially preventable delays in mobilization following surgery frequently occur in elderly patients and are associated with 25% longer LOS and more complex discharge transitions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".