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CU Department of Surgery Research Shows Benefit of Early Ambulation After Lung Surgery

Robert Meguid, MD, MPH, FACS, led the study that showed improvements in overall complications, chest tube duration, pain levels, and length of stay.

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by Greg Glasgow | January 14, 2025
Nurse helping hospital patient walk

Does something as simple as getting a patient up and walking the same day after their lung resection surgery make a difference in their recovery?

“We saw big differences between the patients who walk the same day of surgery and those who don't,” says Meguid, professor of cardiothoracic surgery. “Patients who walk the same day are typically a couple of years younger on average and have shorter operations — it makes sense that you could walk earlier if you had a shorter operation and you have less pain. But even when we adjusted for those factors, we found that the patients who walked the same day as surgery had shorter chest tube duration, shorter associated length of stay in the hospital, lower pain requirements, and a lower overall rate of complications.”

Enhanced recovery protocol

The research — published in November in the Journal of Thoracic Disease — has its roots in an enhanced-recovery-after-surgery protocol implemented in lung surgery patients by the CU Department of Surgery in 2021. One of the more than 100 elements in the patient care bundle aimed at improving recovery and decreasing length of hospital stay is early ambulation — getting patients out of their beds and walking as soon as possible after their surgery.

“Getting them up and moving around gets their lungs expanding and helps their lungs heal,” Meguid says. “It helps prevent pneumonia, deep venous thrombosis, and bed ulcers, and it wakes up their bowels. Those are all physiologic effects of walking, but there’s also a sense of independence, a sense of self control. If a patient can walk, and they can go outside in our glorious Colorado weather, they can get a total change of scenery from their hospital bed.”

For the recently published study, Meguid, Dyas, Stuart and their co-researchers looked at data from across the UCHealth hospital system to compare outcomes for patients who walked the same day as their lung resection surgery — surgery to remove part of the lung, most often as a treatment for lung cancer — and those who didn’t. 

What they found was impressive: The patients who walked the same day were 30% less likely to have complications from the procedure and 23% less likely to get pneumonia. There was a 25% decrease in narcotic requirements for patients who walked the same day, and a 41% decrease in length of stay.

“We’re encouraged to see these results,” Stuart says. “What I think is especially important about this particular study is it demonstrates how patients can engage and participate in their postoperative care in a meaningful way that directly affects their outcomes. I'm hopeful this allows for some of the sense of control that patients often seek in the hospital." 

Putting the numbers into practice

Going forward, Meguid and his team hope to use the data to encourage more early ambulation post-surgery, not just in lung surgery, but in all surgical procedures. There are logistical barriers, Dyas says, but as nurses and other staff are trained in safe ambulation, and as hospitals continue to hire trained ambulatory technicians, the benefits for patients will continue to grow.

“This study can serve to educate administrators so that resources can be invested toward early ambulation,” Dyas says. 

From the hospital’s point of view, “patients are going home sooner. We're saving money,” Meguid says. “More importantly, we're saving lives. We're making an impact on patients’ lives by walking them. Let's see if we can assign more resources to that.

“This is the largest thoracic surgery study to demonstrate this benefit, which was surprising to me,” he adds. “This isn't rocket science. This is low-hanging fruit, easily implementable, that's impactful on our patients. We know it anecdotally. Here's the proof.”

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Robert Meguid, MD, MPH, FACS