Early postoperative recovery is critical in older adults undergoing colorectal cancer surgery, yet the role of early behavioral milestones is underexplored. We therefore examined the association between early postoperative behavioral adherence (mobilization and oral intake within 48 h) and in-hospital recovery efficiency, defined as discharge on or before postoperative day 5 (POD5). This retrospective cohort study included 156 patients aged ≥ 60 years after elective colorectal cancer surgery at a tertiary Chinese hospital (2023–2025). A composite score was developed based on mobilization (≥ 6 h out-of-bed) and oral intake (≥ 50% caloric target) within 48 h post-surgery. Early discharge was defined as ≤ 5 days. Predictors were identified using multivariable logistic regression and path modeling. Among 156 older adults undergoing elective colorectal cancer surgery, early mobilization within 48 h (90% vs. 59%) and early oral intake (83% vs. 56%) were more frequent in patients discharged on or before postoperative day 5 than in those with longer stays (both P < 0.001). In multivariable logistic regression, early mobilization (OR 2.51, 95% CI 1.29–4.90, P = 0.006) and early oral intake (OR 2.14, 95% CI 1.14–4.01, P = 0.018) were independently associated with higher odds of early discharge, whereas a Charlson Comorbidity Index ≥ 2, longer operative time, and open surgery were associated with delayed discharge. Exploratory path analysis suggested that early adherence behaviors may lie on the pathway between surgical factors and discharge timing (CFI = 0.962, RMSEA = 0.054). In this retrospective cohort of older adults undergoing colorectal cancer surgery, higher early postoperative behavioral adherence was independently associated with early in-hospital recovery efficiency. These findings suggest that early mobilization and oral intake may serve as clinically useful markers of favorable early recovery, although prospective interventional studies are needed to confirm causal effects.
Hu et al. (Mon,) studied this question.