Introduction Early ambulation has demonstrated numerous benefits in the postoperative period. Despite the recognized advantages of early ambulation, there exists considerable variability in the time taken by patients to initiate ambulatory activities. Thus, this study aimed to assess the time to early ambulation and its predictors among patients undergoing abdominal surgery in East Gojjam Zone Public Hospitals, Northwest Ethiopia.

Methods Institutional based prospective follow-up study was conducted among 444 patients undergoing abdominal surgery by using systematic sampling. Patients were followed for 24 hours along chart review and interview. After checking the cox proportional hazard assumptions and model fitness test, cox proportional regression analysis model was conducted by using STATA 17 software. Variables with a P value less than 0.2 in the bivariable analysis were selected as candidates for the multivariable cox proportional regression. An adjusted hazard ratio with its 95% CI was used to show the strength of association and P-value less than 0.05 was used to declare statistical significance.

Result From the total of 444 patients undergoing abdominal surgery and followed for 24 hours, 80.6% (95% CI: 0.77-0.84) of them were ambulated. The incidence rate of early ambulation was 5.64% per 100 patient-hours follow up. The median time to early ambulation was 13 hours. Age (AHR = 0.98; 95%CI: (0.97-0.99)), not having catheter (AHR-1.77; 95% CI: (1.37-2.29)), taking tramadol for antipain (AHR-0.26; 95% CI: (0.15-0.45)), postoperative diastolic blood pressure (AHR - 1.01; 95% CI: (1.00-1.02)), and respiratory rate (AHR-0.81; 95% CI: (0.75-0.87)), intraoperative pulse rate(AHR-0.98, 95% CI: (0.97-0.99)), and intraoperative temperature (AHR-1.50, 95% CI: (1.11-2.03)) were found to be predictors of early ambulation.

Conclusion The median time to early ambulation was 13 hours. Thus, health care providers, particularly nurses and surgeons, should actively promote and facilitate early ambulation within 13 hours following abdominal surgery. Increased age, not having catheter, taking tramadol for antipain, postoperative diastolic blood pressure and respiratory rate, intraoperative pulse rate and temperature were predictors of time to early ambulation. As a result, it is better to use antipains other than tramadol in addition to encouraging early ambulation among aged patients.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Data collection was started after the study was approved by the Debre Markos University College of Medicine and Health Science Ethical Review Committee with the reference number RCSD/353/01/16 on the date of 22/09/2016E.C. After that the permission letter was obtained from hospitals. Written informed consent was taken from all study participants, with full right to refuse participating in the study. The confidentiality of the records was preserved throughout the study. Respondents’ responses excluded the names and identifiers of study.

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Address

AE: Afework Edmealem; Mail: afeworkedmealemdmu.edu.et / afeworkyalemgmail.com; Po Box: 269; Debre Markos, Ethiopia

TL: Tiliksew Liknaw; Mail:tiliksewliknaw83gmail.com;Po Box: 269, Debre Markos, Ethiopia

AK: Dr. Anteneh Kehaliw Temesgen; Mail: antekechugmail.com; Po Box: 269, Debre Markos, Ethiopia

TW: Tirusew Wonda; Mail: wondietirusew21gmail.com; Po Box: 269, Debre Markos, Ethiopia

TA: Temesgen Ayenew; Mail: teme31722gmail.com; Po Box: 269, Debre Markos, Ethiopia

SA: Setarg Ayenew: Mail: setargayenewgmail.com; Po Box: 269, Debre Markos, Ethiopia

BA: Bayachew Asmare: Mail: asbia12gmail.com; Po Box: 269, Debre Markos, Ethiopia

BZ: Dr. Bewuketu Zelalem Zeleke; Mail: bewuketuzelalem33gmail.com; Po Box: 269, Debre Markos, Ethiopia

AS: Ayenew Sisay Gebeyew; Mail: ayu.uoggmail.com; Po Box: 269, Debre Markos, Ethiopia

AG: Addisu Getie; Mail: addisugetiegmail.com; Po Box: 269, Debre Markos, Ethiopia

All relevant data are within the manuscript and its supporting information files.