Early mobilization combined with intermittent pneumatic compression for deep vein thrombosis prevention after hepatocellular carcinoma surgery

Table 1 Comparison of baseline data between two groups, n (%)

Indicator	Control group (n = 48)	Observation group (n = 52)	Statistics	P value
Age (years, mean ± SD)	59.8 ± 10.2	60.5 ± 9.7	t = -0.374	0.709
Sex			χ2 = 0.087	0.768
Male	37 (77.1)	41 (78.8)
Female	11 (22.9)	11 (21.2)
BMI (kg/m2, mean ± SD)	23.6 ± 2.8	23.9 ± 2.6	t = -0.572	0.568
Smoking history	22 (45.8)	25 (48.1)	χ2 = 0.052	0.82
Alcohol consumption history	18 (37.5)	19 (36.5)	χ2 = 0.010	0.92
TNM stage			χ2 = 0.428	0.807
Stage I	16 (33.3)	19 (36.5)
Stage II	24 (50.0)	25 (48.1)
Stage III	8 (16.7)	8 (15.4)
Maximum tumor diameter (cm, mean ± SD)	5.4 ± 2.1	5.6 ± 2.3	t = -0.462	0.645
Tumor number			χ2 = 0.196	0.658
Solitary	35 (72.9)	40 (76.9)
Multiple	13 (27.1)	12 (23.1)
Child-Pugh classification			χ2 = 0.182	0.67
Grade A	40 (83.3)	45 (86.5)
Grade B	8 (16.7)	7 (13.5)
AFP [ng/mL, M (P25, P75)]	286.5 (45.8, 1024.3)	312.4 (52.6, 1158.7)	Z = -0.513	0.608
Hypertension	13 (27.1)	12 (23.1)	χ2 = 0.210	0.647
Diabetes	6 (12.5)	8 (15.4)	χ2 = 0.173	0.677
COPD	4 (8.3)	3 (5.8)	1	0.715
Caprini score (points, mean ± SD)	5.2 ± 1.4	5.4 ± 1.3	t = -0.763	0.447

¹Fisher’s exact test.

BMI: Body mass index; COPD: Chronic obstructive pulmonary disease; AFP: Alpha-fetoprotein.

Table 2 Comparison of deep vein thrombosis incidence between two groups, n (%)

Indicator	Control group (n = 48)	Observation group (n = 52)	Statistics	P value
Total DVT incidence	9 (18.8)	3 (5.8)	χ2 = 4.024	0.045
Proximal DVT	4 (8.3)	1 (1.9)	1	0.182
Distal DVT	5 (10.4)	2 (3.8)	1	0.241

¹Fisher’s exact test.

Proximal and distal deep vein thrombosis comparisons are exploratory analyses and were not adjusted for multiple comparisons.DVT: Deep vein thrombosis.

Table 3 Comparison of coagulation parameters between two groups (mean ± SD)

Indicator	Time	Control group (n = 48)	Observation group (n = 52)	t value	P value
D-dimer (mg/L)	1 day preoperatively	0.42 ± 0.15	0.44 ± 0.16	-0.655	0.514
	Postoperative day 1	2.68 ± 0.82	2.54 ± 0.76	0.901	0.37
	Postoperative day 3	3.24 ± 0.95	2.98 ± 0.88	1.434	0.155
	Postoperative day 7	2.86 ± 0.91	2.35 ± 0.72	3.156	0.0021
	Postoperative day 14	1.95 ± 0.68	1.52 ± 0.54	3.558	0.0011
Fib (g/L)	1 day preoperatively	2.95 ± 0.52	3.02 ± 0.48	-0.716	0.476
	Postoperative day 1	4.26 ± 0.78	4.18 ± 0.72	0.546	0.586
	Postoperative day 3	4.82 ± 0.85	4.65 ± 0.81	1.041	0.3
	Postoperative day 7	4.35 ± 0.76	4.22 ± 0.69	0.914	0.363
	Postoperative day 14	3.68 ± 0.64	3.55 ± 0.58	1.083	0.281
PT (seconds)	1 day preoperatively	12.1 ± 0.8	12.2 ± 0.7	-0.673	0.502
	Postoperative day 1	13.8 ± 1.2	13.6 ± 1.1	0.885	0.378
	Postoperative day 3	14.2 ± 1.3	13.9 ± 1.2	1.212	0.228
	Postoperative day 7	13.5 ± 1.1	13.3 ± 1.0	0.967	0.336
	Postoperative day 14	12.8 ± 0.9	12.6 ± 0.8	1.188	0.238
APTT (seconds)	1 day preoperatively	29.8 ± 3.2	30.1 ± 3.4	-0.461	0.646
	Postoperative day 1	35.6 ± 4.1	35.2 ± 3.8	0.516	0.607
	Postoperative day 3	36.8 ± 4.5	36.3 ± 4.2	0.588	0.558
	Postoperative day 7	34.2 ± 3.9	33.8 ± 3.6	0.545	0.587
	Postoperative day 14	31.5 ± 3.5	31.2 ± 3.3	0.451	0.653

¹Statistically significant difference after Bonferroni correction (each indicator was corrected separately for 5 time points, corrected α = 0.01).

Fib: Fibrinogen; PT: Prothrombin time; APTT: Activated partial thromboplastin time.

Table 4 Comparison of lower limb circumference changes between two groups (cm, mean ± SD)

Indicator	Time	Control group (n = 48)	Observation group (n = 52)	t	P value
Thigh circumference	Preoperatively	48.6 ± 4.2	49.1 ± 4.5	-0.585	0.56
	Postoperative day 3	50.8 ± 4.6	49.5 ± 4.3	1.497	0.137
	Postoperative day 7	51.2 ± 4.8	49.2 ± 4.2	2.257	0.026
	Postoperative day 14	50.1 ± 4.5	48.9 ± 4.1	1.407	0.162
Calf circumference	Preoperatively	35.2 ± 3.1	35.6 ± 3.3	-0.634	0.527
	Postoperative day 3	37.1 ± 3.5	36.0 ± 3.2	1.664	0.099
	Postoperative day 7	37.8 ± 3.7	35.9 ± 3.2	2.785	0.0061
	Postoperative day 14	36.5 ± 3.4	35.7 ± 3.1	1.259	0.211

¹Statistically significant difference after Bonferroni correction (corrected for 4 time points, corrected α = 0.0125).

Measurement sites are 10 cm above the superior border of patella (thigh circumference) and 10 cm below the inferior border of patella (calf circumference).

Table 5 Comparison of early mobilization compliance and functional recovery indicators between two groups

Indicator	Control group (n = 48)	Observation group (n = 52)	Statistics	P value
Time to first ambulation (hour, mean ± SD)	54.6 ± 8.2	26.8 ± 4.5	t = 20.894	< 0.001
Daily activity time on postoperative day 3 (minutes, mean ± SD)	45.3 ± 12.6	128.5 ± 24.3	t = -21.643	< 0.0012
Daily activity time on postoperative day 7 (minutes, mean ± SD)	92.6 ± 18.4	185.7 ± 32.5	t = -17.434	< 0.0012
VAS pain score (points, mean ± SD)
Postoperative day 3	3.9 ± 1.3	3.7 ± 1.2	t = 0.813	0.418
Postoperative day 7	3.6 ± 1.1	3.4 ± 1.0	t = 0.958	0.34
BI score (points, mean ± SD)
1 day preoperatively	95.2 ± 5.8	94.8 ± 6.2	t = 0.341	0.734
Postoperative day 7	62.5 ± 8.6	71.3 ± 9.2	t = -5.017	< 0.0011
Postoperative day 14	78.4 ± 7.9	86.2 ± 8.5	t = -4.802	< 0.0011
KPS score (points, mean ± SD)
1 day preoperatively	88.3 ± 6.5	89.0 ± 6.8	t = -0.532	0.596
Postoperative day 7	64.2 ± 7.8	72.5 ± 8.3	t = -5.210	< 0.0011
Postoperative day 14	75.6 ± 7.2	82.8 ± 7.6	t = -4.889	< 0.0011
Independent walking distance (m, mean ± SD)
Postoperative day 7	28.5 ± 8.6	65.3 ± 12.4	t = -17.262	< 0.0013
Postoperative day 14	58.7 ± 12.3	125.8 ± 18.6	t = -21.229	< 0.0013

¹Statistically significant difference after Bonferroni correction (Barthel Index and Karnofsky Performance Status were each corrected for 3 time points, corrected α = 0.0167).

²Statistically significant difference after Bonferroni correction (corrected for postoperative days 3 and 7, 2 time points, corrected α = 0.025).

³Statistically significant difference after Bonferroni correction (corrected for postoperative days 7 and 14, 2 time points, corrected α = 0.025).

VAS: Visual Analog Scale; BI: Barthel Index; KPS: Karnofsky Performance Status.