Abstract
Objectives: A key element in enhanced postoperative recovery is early mobilization. However, this may be hindered by orthostatic hypotension (OH). The purpose of the present study was to investigate the incidence of OH during early mobilization and to identify independent risk factors for OH in patients after gastrectomy for gastric cancer. Methods: A total of 211 patients who had undergone elective gastrectomy for gastric cancer with perioperative physiotherapy between 2004 and 2011 were examined. The causative factors and incidence of OH were all clearly reported in the clinical records. Results: The incidence of OH on day 1 after gastrectomy was 37% (78 cases). In the multiple logistic regression model, ischemic heart disease [odds ratio (OR) 2.317, 95% confidence interval (CI) 1.118-4.805, P = 0.024], the postoperative serum albumin level (OR 0.362, 95%CI 0.180-0.725, P = 0.004), the postoperative WBC count (OR 1.008, 95%CI 1.000-1.017, P = 0.043) and postoperative mean arterial pressure (OR 0.968, 95%CI 0.947-0.991, P = 0.006) were identified as independent risk factors for OH. Conclusion: The early posture cardiovascular response is impaired after gastrectomy, thus leading to a high incidence of OH. The presence of ischemic heart disease, the postoperative serum albumin level, the postoperative WBC count and postoperative mean arterial pressure were significant factors for the development of OH.
