Association among preoperative comorbidities, targeted nursing interventions, and postoperative recovery in patients undergoing total gastrectomy for gastric cancer

Table 1 Baseline characteristics of patients stratified by comorbidity severity, mean ± SD

Variable	Comorbidity 0	Comorbidity 1	Comorbidity 2	P value
Age (year)	66.94 ± 9.51	68.54 ± 8.45	62.77 ± 11.87	0.172
Male sex, n (%)	104 (83.9)	30 (81.1)	10 (76.9)	0.785
BMI (kg/m2)	21.01 ± 1.08	20.59 ± 1.22	19.77 ± 1.43	< 0.001
Hemoglobin (g/dL)	13.38 ± 0.89	13.07 ± 0.86	12.60 ± 1.29	0.006
Albumin (g/L)	37.22 ± 1.86	34.34 ± 1.96	34.98 ± 1.57	< 0.001
ASA physical status				< 0.001
ASA I	24	1	0
ASA II	75	22	4
ASA III & IV	25	14	9

BMI: Body mass index; ASA: American Society of Anesthesiologists.

Table 2 Perioperative nursing process indicators according to comorbidity severity, mean ± SD

Indicator (day)	Comorbidity 0	Comorbidity 1	Comorbidity 2	P value
Preoperative waiting time	3.65 ± 2.04	3.35 ± 1.92	4.46 ± 3.13	0.266
Time to first ambulation	2.50 ± 0.28	2.74 ± 0.20	3.48 ± 0.12	< 0.001
Time to first oral intake	3.30 ± 0.28	3.54 ± 0.20	4.38 ± 0.12	< 0.001
Time to NG tube removal	4.00 ± 0.28	4.24 ± 0.20	5.28 ± 0.12	< 0.001

NG: Nasogastric.

Table 3 Postoperative recovery outcomes by comorbidity severity, mean ± SD

Outcome	Comorbidity 0	Comorbidity 1	Comorbidity 2	P value
Postoperative recovery time (day)	8.25 ± 2.13	8.00 ± 2.01	8.62 ± 2.14	0.643
Length of hospital stay (day)	11.90 ± 2.78	11.35 ± 2.51	13.08 ± 3.48	0.157
Delayed recovery (≥ 8 days), n (%)	69 (55.6)	17 (45.9)	9 (69.2)	0.321

Table 4 Association between nursing process indicators and postoperative recovery, n/total (%)

Nursing indicator	Category	Delayed recovery ≥ 8 days	P value
Time to first ambulation (day)	≤ 2	3/6 (50.0)	1.000
	> 2	92/168 (54.8)
Time to first oral intake (day)	≤ 3	6/23 (26.1)	0.006
	> 3	89/151 (58.9)
NG tube removal time (day)	≤ 4	34/72 (47.2)	0.137
	> 4	61/102 (59.8)

NG: Nasogastric.

Table 5 Multivariable logistic regression analysis for delayed recovery (≥ 8 days)

Variable	Adjusted OR	95%CI	P value
Age (per year)	0.961	0.922-1.002	0.06
Male sex	2.34	0.958-5.716	0.062
Comorbidity severity	0.313	0.135-0.722	0.006
Time to first oral intake (day)	17.179	3.540-83.373	< 0.001

Table 6 Correlation between comorbidity severity and American Society of Anesthesiologists physical status

Comorbidity severity	ASA I	ASA II	ASA III-IV	P value
0	24	75	25	< 0.001
1	1	22	14
2	0	4	9

ASA: American Society of Anesthesiologists.