LOS post-op not affected by sleep quality, step count

Neither sleep quality nor step count had a bearing on length of hospital stay (LOS) following bowel surgery in patients with inflammatory bowel disease (IBD), according to researchers at the recent AIBD 2019 Meeting.

There were no significant associations between mean sleep duration, mean sleep efficiency, or mean daily steps and post-operative LOS in IBD patients in this study, as measured by a wearable biosensor device (Fitbit). [AIBD 2019, abstract P110]

However, investigator Yangtian Yi, a medical student at the University of Chicago in Chicago, Illinois, US, admitted that only 64 percent of patients wore the device while sleeping, and about 82 percent wore it for step data. When asked why adherence was a problem for a device that is meant to be worn as a bracelet,  Yi said patients were reported as saying that the device “ isn’t comfortable to wear during sleep” particularly for those sleeping on their sides.

Co-author Dr David Rubin, from the same institution, said another downside could be that the device had to be recharged. “People take it off and go to the shower and they don’t put it back on.”

Yi and team looked into 22 patients, 17 of them had Crohn’s disease and five had ulcerative colitis. At the time of surgery, mean age of the patients was 41. Thirteen of them were females. Nineteen were Caucasian. Ileocolectomy was the most common operative procedure (in nine patients) performed. Eight had ileostomy, 13 had laparoscopic procedures, four had open procedures. Mean hospital LOS was 5 days.

As expected, more complications were associated with longer LOS. These included anaemia, urinary retention, and vomiting which was the most reported. Moving on, the researchers said they intend to do a prospective interventional study to assess the effects of sleep quality on LOS by encouraging early ambulation and providing a conducive environment to improve sleep.

Yi said there was a dearth of studies looking at the association between physical activity and post-operative LOS in patients with IBD. This was despite the fact that a large number of IBD patients would require surgery.

He emphasized that early mobilization is a key component of perioperative care for enhanced recovery after abdominal surgery, and the presence of obstructive sleep apnoea may be associated with a longer LOS after a non-cardiac surgery.