Early ambulation after surgery in children with cerebral arteriovenous malformations: associated factors and care strategies

Background Early postoperative ambulation plays a crucial role in accelerating postoperative recovery in pediatric patients. This study aimed to analyze the current status and associated factors of early ambulation after surgery in children with cerebral arteriovenous malformations (AVMs). Methods This study retrospectively enrolled pediatric patients with AVMs treated in our hospital between January 2022 and May 2025. Early postoperative ambulation was defined as the initiation of phased, progressive mobility within 12–48 h after surgery, based on pediatric neurosurgical ERAS principles to balance safety and recovery benefits. Clinical data of patients were collected and compared into two groups based on whether they underwent early postoperative ambulation. Results A total of 156 pediatric patients with cerebral AVMs were enrolled, yielding an overall early postoperative ambulation rate of 39.74%. Correlation analyses identified statistically significant associations between early ambulation and five key variables: age ( r = 0.613), admission Glasgow Coma Scale (GCS) score ( r = 0.579), Spetzler-Martin classification ( ρ = −0.616), surgical duration ( r = −0.597), and parental education level ( ρ = 0.586; all p < 0.05). Pearson’s correlation coefficients were used for continuous variables, while Spearman’s rank correlation coefficients were applied to ordinal categorical variables. Multivariate logistic regression analysis confirmed that children aged < 8 years (OR = 2.881, 95% CI: 1.820–3.633), those with admission GCS scores < 12 (OR = 2.900, 95% CI: 1.653–3.475), severe Spetzler-Martin classification (Grades III–V; OR = 3.021, 95% CI: 2.532–3.955), surgical duration ≥ 240 min (OR = 1.933, 95% CI: 1.251–2.604), and lower parental education level (OR = 1.681, 95% CI: 1.103–2.055) had significantly higher odds of not undergoing early ambulation (all p < 0.05). Conclusion The rate of early postoperative ambulation in children with cerebral AVMs remains suboptimal, highlighting the need for targeted improvement strategies. Clinically, these findings underscore the importance of designing and implementing targeted nursing interventions that address these specific associated factors, with the goal of enhancing postoperative recovery in this vulnerable population.