Analysis of influencing factors of initial ambulation after posterior lumbar fusion and internal fixation
YANG Yiqin1 HU Sanlian2▲ QIAN Huijuan2 ZHOU Ling3 CUI Lingling3
1.School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China;
2.Department of Nursing, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China; 3.Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
Abstract：Objective To investigate the status quo and influencing factors of first ambulation after posterior lumbar fusion and internal fixation. Methods A total of 328 patients admitted to the Department of Spinal Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University from April to September 2021 after posterior lumbar fusion and internal fixation were selected as subjects by convenience sampling method. Patients who got out of bed for the first time within three days after surgery were in the early stage of getting out of bed and being able to complete bed chair transfer or sitting or standing or walking on the ground beside the bed; otherwise, it was the non-early exfoliation group. The general data questionnaire, the generalized anxiety scale (GAD-7), and the medical-social support scale were used to investigate, while the factors affecting the first postoperative movement of patients with posterior lumbar fusion and internal fixation were analyzed by multiple logistic regression. Results Univariate analysis showed that there were statistically significant differences in age, postoperative hemoglobin, osteoporosis, pain score, indignant urinary catheter, surgical method, social support score, and anxiety between the two groups (P＜0.05). Logistic regression results showed that age (≥60 years old), postoperative hemoglobin (high), osteoporosis (yes), pain score (≥5 points), indent catheter (yes), operation method (operation), anxiety (moderate to severe) were the risk factors affecting the time of getting out of bed (OR＞1, P＜0.05); social support (good) was a protective factor affecting the time of patients getting out of bed (OR＜1, P＜0.05). Conclusion Higher postoperative hemoglobin and good level of medical and social support can improve the early postoperative activity level of patients with posterior lumbar fusion and internal fixation, which has important significance to promote their rehabilitation. Older age, osteoporosis, moderate to severe anxiety, indwelling catheter and other risk factors.
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