Mobility scores as a predictor of length of stay in general surgery: a prospective cohort study

Carroll, Georgia; Hampton, Jacob; Carroll, Rosemary; Smith, Stephen R.

doi:10.1111/ans.14555

Cited by 8 publications

(10 citation statements)

References 17 publications

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“…To the best of our knowledge, this is the first study to explore the relationship between DEMMI scoring and sarcopenia. While previous research has indicated that the DEMMI score is a useful tool for determining patient outcomes, 12–14 we did not see an association with sarcopenia. This may possibly be due to the skewed DEMMI scores (median DEMMI = 100) seen in our study, reflecting a high level of pre‐operative mobility.…”

Section: Discussioncontrasting

confidence: 97%

“…11 After general surgical procedures, a worse pre-operative DEMMI score is associated with longer inpatient admission. 12 It has been increasingly used for predicting functional recovery after surgery. 13,14 Despite a close relationship between mobility scores and sarcopenia, the association between DEMMI score and sarcopenia has not been established.…”

Section: Introductionmentioning

confidence: 99%

“…Whilst initially validated for hospitalized older acute medical patients, it has been shown to be a useful tool in the perioperative setting 11 . After general surgical procedures, a worse pre‐operative DEMMI score is associated with longer inpatient admission 12 . It has been increasingly used for predicting functional recovery after surgery 13,14 .…”

Section: Introductionmentioning

confidence: 99%

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C1q and mobility score in predicting sarcopenia in an Australian cohort of cancer surgery patients

Senanayake

Loh

Carroll

et al. 2022

ANZ Journal of Surgery

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Background Sarcopenia has been shown to have significant adverse health outcomes in a range of patient populations. Particularly, sarcopenic patients having cancer surgery are a unique group who demonstrate poorer post‐operative outcomes. Currently, the gold standard in diagnosing sarcopenia is through the use of computed tomography. However, the widespread use of imaging to diagnose patients with sarcopenia is neither cost‐effective nor practical. Identifying a serum biomarker or a simple mobility scoring system as an alternative diagnostic tool may aid in identifying more patients at risk of sarcopenia. C1q, a novel biomarker, has previously been shown to correlate with sarcopenia. Similarly, we sought to explore whether mobility scores may provide a useful surrogate marker for sarcopenia. Methods This was a prospective cohort study of patients who presented for colorectal cancer surgery between the dates of 6/10/2016 and 4/10/2017 at John Hunter Hospital. Computed tomography was utilized to calculate the psoas area at the L3 spinal level. Pre‐operative blood samples were obtained for C1q analysis and de Morton Mobility Index (DEMMI) was also performed. Results A total of 51 patients were included in the study. The median age of the patients were 69 years old. We did not demonstrate a correlation between serum C1q and DEMMI scores with psoas area. Conclusion Our findings suggest that neither C1q nor DEMMI scores are correlated with psoas area in a colorectal cancer population.

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Section: Discussioncontrasting

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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C1q and mobility score in predicting sarcopenia in an Australian cohort of cancer surgery patients

Senanayake

Loh

Carroll

et al. 2022

ANZ Journal of Surgery

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“…A study where DEMMI is performed in surgical patients (20–87 years), documents that the DEMMI score can predict discharge within 1 week [30]. The present study confirms these results in an acute geriatric population, although the predictive accuracy that we show is slightly lower.…”

Section: Discussionsupporting

confidence: 84%

DEMMI Scores, Length of Stay, and 30-Day Readmission of Acute Geriatric Patients in Denmark: A Cross-Sectional Observational Study with Longitudinal Follow-Up

et al. 2019

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The aims of this study are to describe the mobility of acute geriatric patients, the length of stay, and to characterise patients who were readmitted within 30 days based on the De Morton Mobility Index (DEMMI). A cross-sectional observational study with longitudinal follow-up was conducted in the period from 1 March 2016 to 31 August 2016. Inclusion criteria were acute geriatric patients hospitalised for a minimum of 24 h. Of the 418 patients hospitalised during the study period, 246 (59%) participated in this study (44% male, median age 83 years [70; 94]). For patients in an acute geriatric department, the median DEMMI score was 41 and the mean score was 39.95. Patients with a DEMMI score ≤40 show a significantly lower Barthel 100 index, lower 30 s. sit-to-stand scores and were significantly more likely to be bedridden or, amongst those not bedridden, to use a mobility aid. Lower DEMMI scores were associated with longer admissions. DEMMI seems to have the ability to predict discharge within one week. There was no significant association between a lower DEMMI score and higher risk for 30-day readmission. Further research is needed to determine whether the DEMMI is suitable for identifying the patient’s need for further rehabilitation following the discharge.

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“…The DEMMI has been validated for use in mobility assessment as an initial tool and for generating intrapatient interval change comparative data . It has also been validated in the surgical setting by objectively determining readiness for discharge and LOS for patients following colectomy . As a result, it has been used in previous research to compare functional outcomes following colectomy and appeared to be a sensitive discriminator of recovery in this trial .…”

Section: Discussionmentioning

confidence: 99%

The LAPLAP study: a randomized placebo‐controlled clinical trial assessing postoperative functional recovery using intraperitoneal local anaesthetic in laparoscopic colorectal surgery

et al. 2019

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Aim Postoperative pain remains a major factor in recovery from colorectal resection. There is increasing interest in opioid‐sparing analgesia, and intraperitoneal local anaesthetic (IPLA) has recently been shown to be useful in minor laparoscopic and open colorectal procedures. The aim of this study was to evaluate the impact of IPLA on functional recovery following major laparoscopic surgery. In this controlled trial, mobility, as measured by the De Morton Mobility Index (DEMMI), was used as a surrogate for postoperative functional recovery. Method Patients undergoing laparoscopic colorectal resection were randomized either to continuous ropivacaine (0.2% at 4–6 ml/h) or to saline (0.9%) which were administered via intraperitoneal catheter for 3 days postoperatively. Results were analysed in a double‐blind manner. DEMMIs were assessed on postoperative days 1, 2, 3, 7 and 30, and data on pain, opioid consumption, gut and respiratory function, length of stay (LOS) and complications were recorded. Results Ninety‐six patients were recruited. There was no difference in primary outcome (i.e., functional recovery) between IPLA and placebo groups. Opioid consumption and LOS were similar between groups, and no differences were found for any secondary outcome measure. There were no adverse events related to ropivacaine. Conclusion Infusional intraperitoneal local anaesthetic appears to be safe but does not improve functional recovery or analgesic consumption following elective laparoscopic colorectal surgery, in the setting of an established enhanced recovery programme.

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Mobility scores as a predictor of length of stay in general surgery: a prospective cohort study

Cited by 8 publications

References 17 publications

C1q and mobility score in predicting sarcopenia in an Australian cohort of cancer surgery patients

C1q and mobility score in predicting sarcopenia in an Australian cohort of cancer surgery patients

DEMMI Scores, Length of Stay, and 30-Day Readmission of Acute Geriatric Patients in Denmark: A Cross-Sectional Observational Study with Longitudinal Follow-Up

The LAPLAP study: a randomized placebo‐controlled clinical trial assessing postoperative functional recovery using intraperitoneal local anaesthetic in laparoscopic colorectal surgery

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