title: The preoperative level of physical activity is associated to the postoperative recovery after elective cholecystectomy - A cohort study.
abstract: BACKGROUND
  There is an increasing interest in the role of preoperative physical activity for postoperative recovery. The effect of preoperative physical activity and recovery after cholecystectomy is unknown. The aim of this study was to evaluate the association of self-reported leisure-time preoperative physical activity with postoperative recovery and complications after elective cholecystectomy due to gallstone disease.
  
  
  METHODS
  Prospective observational cohort study with 200 patients scheduled to undergo elective cholecystectomy. Level of self-assessed leisure-time physical activity was compared with recovery.
  
  
  RESULTS
  Regular physical activity was associated with a higher degree of return to work within three weeks post-operatively (relative chance (RC) 1.26, p = 0.040); with a higher chance of leaving hospital within one day post-op (RC 1.23, p = 0.001), as well as with better mental recovery (RC 1.18, p = 0.049), compared to physically inactive. No statistically significant association was seen with return to work within one week or with self-assessed physical recovery.
  
  
  CONCLUSIONS
  In clinical practice, evaluating the patients' level of physical activity is feasible, and may potentially be used to identify patients being more suitable for same-day surgery. Given the study design, the results from this study cannot prove causality.
  
  
  CONCLUSIONS
  The present study shows that the preoperative leisure-time physical activity-level, is positively associated with less sick leave, a shorter hospital stay and with better mental recovery, three weeks post-elective cholecystectomy. We recommend assessing the physical activity-level preoperatively for prognostic reasons. If preoperative/postoperative physical training will increase recovery remains to be shown in a randomized controlled study.
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden. Electronic address: aron.onerup@gu.se.
authors.forename: Aron
authors.initials: A
authors.lastname: Onerup
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Angerås
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: David
authors.initials: D
authors.lastname: Bock
authors.affiliation: Swedish School of Sport and Health Sciences and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Börjesson
authors.affiliation: Department of Gastrosurgical Research and Education, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Department of Physical Therapy and Surgery Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Monika
authors.initials: M
authors.lastname: Fagevik Olsén
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; School of Business, Economics and IT, University West, Trollhättan, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Gellerstedt
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Haglind
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Nilsson
authors.affiliation: Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Angenete
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007899:Leisure Activities; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D062707:Return to Work; D016896:Treatment Outcome
keywords: Cholecystectomy; Length of hospital stay; Physical activity; Preoperative; Recovery; Return to work