Objectively Measured Preoperative Physical Activity is Associated with Time to Functional Recovery After Hepato-pancreato-biliary Cancer Surgery: a Pilot Study

Overview

Journal Perioper Med (Lond)

Publisher Biomed Central

Date 2021 Oct 4

PMID 34602089

Citations 8

Authors

Caspar F Mylius

Wim P Krijnen

Tim Takken

Daan J Lips

Hasan Eker

Cees P van der Schans

Joost M Klaase

Affiliations

Soon will be listed here.

Abstract

Background: Surgical resection is currently the cornerstone of hepato-pancreato-biliary (HPB) cancer treatment. A low preoperative aerobic fitness level has been identified as a modifiable risk factor associated with complications after major abdominal surgery. A person's aerobic fitness is influenced by performing moderate to vigorous physical activity (MVPA). This study aims to determine the activity monitor measured levels of MVPA performed among patients on the waiting list for HPB cancer surgery and their association with postoperative outcomes.

Methods: A prospective, observational multi-center cohort pilot study was conducted. Patients enlisted for resection surgery on suspicion of HPB (pre)malignancy were enrolled. Performed MVPA was measured by an Actigraph wGT3X-BT. Additionally, aerobic fitness was measured via the Incremental Shuttle Walk Test, and (post)operative variables were collected from the electronic patient files. The association between MVPA and the pre- and postoperative variables was determined by univariate and multivariable (logistic) robust regression.

Results: A total of 38 participants, median age 66.0 (IQR 58.25-74.75) years, were enrolled. The median daily MVPA was 10.7 (IQR 6.9-18.0) min; only 8 participants met the Dutch MVPA guidelines. Participant's age and aerobic fitness were associated with MVPA by multivariable statistical analysis. Time to functional recovery was 8 (IQR 5-12) days and was associated with MVPA and type of surgery (major/minor) in multivariable analysis.

Conclusion: Seventy-six percent of patients enlisted for resection of HPB (pre)malignancy performed insufficient MVPA. A higher level of MVPA was associated with a shorter time to functional recovery.

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References

Pinto A, Faiz O, Davis R, Almoudaris A, Vincent C . Surgical complications and their impact on patients' psychosocial well-being: a systematic review and meta-analysis. BMJ Open. 2016; 6(2):e007224. PMC: 4762142. DOI: 10.1136/bmjopen-2014-007224. View

Singh S, Morgan M, Scott S, Walters D, Hardman A . Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax. 1992; 47(12):1019-24. PMC: 1021093. DOI: 10.1136/thx.47.12.1019. View

Probst V, Hernandes N, Teixeira D, Felcar J, Mesquita R, Goncalves C . Reference values for the incremental shuttle walking test. Respir Med. 2011; 106(2):243-8. DOI: 10.1016/j.rmed.2011.07.023. View

Pearse R, Moreno R, Bauer P, Pelosi P, Metnitz P, Spies C . Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012; 380(9847):1059-65. PMC: 3493988. DOI: 10.1016/S0140-6736(12)61148-9. View

Dronkers J, Chorus A, van Meeteren N, Hopman-Rock M . The association of pre-operative physical fitness and physical activity with outcome after scheduled major abdominal surgery. Anaesthesia. 2012; 68(1):67-73. DOI: 10.1111/anae.12066. View

Chastin S, De Craemer M, De Cocker K, Powell L, Van Cauwenberg J, Dall P . How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies. Br J Sports Med. 2018; 53(6):370-376. PMC: 6579499. DOI: 10.1136/bjsports-2017-097563. View

Hallal P, Andersen L, Bull F, Guthold R, Haskell W, Ekelund U . Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012; 380(9838):247-57. DOI: 10.1016/S0140-6736(12)60646-1. View

Vassbakk-Brovold K, Kersten C, Fegran L, Mjaland O, Mjaland S, Seiler S . Cancer patients participating in a lifestyle intervention during chemotherapy greatly over-report their physical activity level: a validation study. BMC Sports Sci Med Rehabil. 2016; 8:10. PMC: 4837555. DOI: 10.1186/s13102-016-0035-z. View

Stanojevic S, Wade A, Stocks J . Reference values for lung function: past, present and future. Eur Respir J. 2010; 36(1):12-9. DOI: 10.1183/09031936.00143209. View

10.

Kontis V, Bennett J, Mathers C, Li G, Foreman K, Ezzati M . Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble. Lancet. 2017; 389(10076):1323-1335. PMC: 5387671. DOI: 10.1016/S0140-6736(16)32381-9. View

11.

Choi L, Liu Z, Matthews C, Buchowski M . Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc. 2010; 43(2):357-64. PMC: 3184184. DOI: 10.1249/MSS.0b013e3181ed61a3. View

12.

Straatman J, Cuesta M, de Lange-de Klerk E, van der Peet D . Hospital cost-analysis of complications after major abdominal surgery. Dig Surg. 2015; 32(2):150-6. DOI: 10.1159/000371861. View

13.

Knaier R, Hochsmann C, Infanger D, Hinrichs T, Schmidt-Trucksass A . Validation of automatic wear-time detection algorithms in a free-living setting of wrist-worn and hip-worn ActiGraph GT3X. BMC Public Health. 2019; 19(1):244. PMC: 6393958. DOI: 10.1186/s12889-019-6568-9. View

14.

Moran J, Wilson F, Guinan E, McCormick P, Hussey J, Moriarty J . The preoperative use of field tests of exercise tolerance to predict postoperative outcome in intra-abdominal surgery: a systematic review. J Clin Anesth. 2016; 35:446-455. DOI: 10.1016/j.jclinane.2016.09.019. View

15.

Gorman E, Hanson H, Yang P, Khan K, Liu-Ambrose T, Ashe M . Accelerometry analysis of physical activity and sedentary behavior in older adults: a systematic review and data analysis. Eur Rev Aging Phys Act. 2014; 11:35-49. PMC: 3990855. DOI: 10.1007/s11556-013-0132-x. View

16.

Riall T . What is the effect of age on pancreatic resection?. Adv Surg. 2009; 43:233-49. PMC: 2855222. DOI: 10.1016/j.yasu.2009.02.004. View

17.

Lovasik B, Kron P, Clavien P, Petrowsky H, Kooby D . Pancreatectomy and body mass index: an international evaluation of cumulative postoperative complications using the comprehensive complications index. HPB (Oxford). 2019; 21(12):1761-1772. DOI: 10.1016/j.hpb.2019.04.006. View

18.

Prince S, Adamo K, Hamel M, Hardt J, Connor Gorber S, Tremblay M . A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008; 5:56. PMC: 2588639. DOI: 10.1186/1479-5868-5-56. View

19.

Levett D, Grocott M . Cardiopulmonary exercise testing, prehabilitation, and Enhanced Recovery After Surgery (ERAS). Can J Anaesth. 2015; 62(2):131-42. PMC: 4315486. DOI: 10.1007/s12630-014-0307-6. View

20.

Milanovic Z, Pantelic S, Trajkovic N, Sporis G, Kostic R, James N . Age-related decrease in physical activity and functional fitness among elderly men and women. Clin Interv Aging. 2013; 8:549-56. PMC: 3665513. DOI: 10.2147/CIA.S44112. View