Objective: The primary aim of the study is to evaluate the physical function performance differences between those who develop complications and those who do not and determine their impact on recovery. Background: Complication rates in abdominal (colorectal, hernia repair & cholecystectomies) surgery are variable and appear to be lower in minimally invasive, less complex surgery. Complications are associated with significant costs in terms of morbidity, finance, psychological and impact on recovery. Factors that have been identified as associated with complications include age, BMI, surgical approach, co-morbidities, American Society of Anaesthesiologists (ASA) status, physical function frailty and level of dependency. It is also clear that these factors individually are unlikely predictors but highlight the need for multifactorial assessment. Surgical procedures in their essence cause significant physiological stress which can often mimic similar physiological effects of exercise. Cardiopulmonary exercise testing (CPET) can be useful in predicting complications, however is generally unavailable and not always suitable. No one measure has been identified to predict complications in an abdominal surgery population, hence the need to evaluate physical function performance as a whole and analyse differences that may emerge between those who develop complications and those who do not. Methods: Participants were recruited (n = 49) via the pre-operative assessment unit in the University Hospital Limerick. Pre-operative assessment included the following: demographics data, six-minute walk distance, VO2Peak, spirometry, peak cough flow, self-reported activity using the International Physical Activity Questionnaire (IPAQ), ASA score, surgical Physical function performance and recovery of patients undergoing abdominal surgery in relation to complications-A prospective real world study-4-grade, Malnutrition Universal Scoring Tool (MUST) score, albumin and creatinine levels. Post-surgery data included surgery type, length, surgical approach, initial 24-hour pain relief, length of stay and complications. At 30 and 60 days, participants were contact via telephone and the telephone IPAQ repeated, questioned regarding their self-assessed physical recovery and post hospital discharge complications. Results: Surgery types fell into the following 4 categories: colorectal (n = 21), colorectal reversals (n = 7), hernia repairs (n = 10) and cholecystectomies (n = 5). The complications rate was 41.9% (n=18) pre-discharge, 30.2% (n=13) at 30 day's post-surgery and 21% (n = 9) at 60 day's post-surgery. Obesity (P=0.005*), longer operating time (P=0.05*), >2 co-morbidities (P = 0.033*), low activity levels (P=0.020*), low VO2Peak (P=0.017*) and lower 6-minute walk distance (P=0019*) were statistically different between complications and non-complications groups with worse scores seen in the complications group. Length of stay was significantly increased in the complications groups at a median of 8.5 nights versus 2 nights in the non-compl...
BACKGROUND: The relationship between physical function and the development of complications in people after abdominal surgery is not well known. The objective of this study was to prospectively examine the relationship between simple physical functioning tests and complications following abdominal surgery. METHODS: Participants were recruited from an elective surgery waiting list. The following variables were measured pre-surgery; functional capacity (Six Minute Walk Test, 30 Second Sit to Stand Test), grip strength (hand dynamometer), self-report physical activity [International Physical Activity Questionnaire, (IPAQ)]. At 30 and 60 days post-operatively IPAQ and self-reported recovery were collected by telephone. Data related to complications and length of stay was extracted from the medical chart. RESULTS: Forty-nine participants (25M/18F) were recruited with a mean (SD) age of 59.5 (14.7) years. The complication rate was 41.9% (n = 18). Factors which differed between the complications and no complications groups were; longer operating time (p = 0.05),>2 co-morbidities (p = 0.033), body mass index >30 (p = 0.005), lower activity levels (p = 0.02), VO2 Peak (p = 0.017) and 6-minute walk distance (p = 0.019). There was an increased length of stay (p < 0.001) and sedentary time (p = 0.007) in the complications group. Activity levels reduced in the whole group (p < 0.001) even though self-report physical activity and recovery were high. CONCLUSION: A number of potentially modifiable physical functioning factors differed in the complication versus no complication groups. Future studies should evaluate whether optimizing physical functioning pre-operatively could alter complication rates and recovery in patients undergoing abdominal surgery.
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