title: The association of pre-operative physical fitness and physical activity with outcome after scheduled major abdominal surgery.
abstract: 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.
authors.affiliation: Gelderse Vallei Hospital, Ede, the Netherlands. dronkersj@zgv.nl
authors.forename: J J
authors.initials: JJ
authors.lastname: Dronkers
authors.forename: A M J
authors.initials: AM
authors.lastname: Chorus
authors.forename: N L U
authors.initials: NL
authors.lastname: van Meeteren
authors.forename: M
authors.initials: M
authors.lastname: Hopman-Rock
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006225:Hand / Q000502:physiology; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007866:Leg / Q000502:physiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology; D010351:Patient Discharge; D010809:Physical Fitness / Q000502:physiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000401:mortality; D016019:Survival Analysis; D016896:Treatment Outcome