The association of pre‐operative physical fitness and physical activity with outcome after scheduled major abdominal surgery

• Published in: Anaesthesia 2013-01, Vol.68 (1), p.67-73
• Main Authors: Dronkers, J. J., Chorus, A. M. J., Meeteren, N. L. U., Hopman‐Rock, M.
• Format: Article
• Language: English
• Subjects: Abdomen - surgery; Abdominal surgery; Aged; Aged, 80 and over; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cancer; Cohort Studies; Exercise; Female; Hand - physiology; Hand Strength - physiology; Humans; Leg - physiology; Length of Stay; Male; Medical sciences; Middle Aged; Motor Activity - physiology; Muscle Strength - physiology; Patient Discharge; Physical fitness; Physical Fitness - physiology; Postoperative Complications - epidemiology; Prospective Studies; Risk Factors; ROC Curve; Surgical outcomes; Surgical Procedures, Operative - mortality; Survival Analysis; Treatment Outcome
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/anae.12066

Summary We studied whether reported physical activity and measurements of fitness (hand, leg and inspiration) were associated with postoperative in‐hospital mortality, length of stay and discharge destination in 169 patients after major oncological abdominal surgery. In multivariate analysis, adequate activity level (OR 5.5, 95% CI 1.4–21.9) and inspiratory muscle endurance (OR 5.2, 95% CI 1.4–19.1) were independently associated with short‐term mortality, whereas conventional factors, such as age and heart disease, were not. Adequate activity level (OR 6.7, 95% CI 1.4–3.0) was also independently associated with discharge destination. The factors that were independently associated with a shorter length of hospital stay were as follows: absence of chronic obstructive pulmonary disease (HR 0.6, 95% CI 0.3–1.1); adequate activity level (HR 0.6, 95% CI 0.4–0.8); and inspiratory muscle strength (HR 0.6, 95% CI 0.5–0.9). For all postoperative outcomes physical activity and fitness significantly improved the predictive value compared with known risk factors, such as age and comorbidities. We conclude that pre‐operative questionnaires of physical activity and measurements of fitness contribute to the prediction of postoperative outcomes.