65 - Preissitzung
16. Mai 2019, 13:45 - 15:15, Sopra 3, 4. OG
Physical activity and outcomes in colorectal surgery: A prospective cohort study using connected bracelets
D. Martin1, B. Romain2, B. Pache1, A. Vuagniaux1, V. Guarnero1, D. Hahnloser1, N. Demartines1, M. Hübner1, Presenter: D. Martin1 (1Lausanne, 2Strasbourg/FR)
Physical activity is an essential element of postoperative recovery. The aim of this prospective study was to examine the associations between perioperative physical activity and postoperative outcomes in colorectal surgery.
Daily number of footsteps was recorded from preoperative day 5 to postoperative day 3 in a prospective cohort of colorectal patients using connected wrist bracelets. Timed Up and Go Test (TUGT), 6 Minutes Walking Test (6MWT) and peak expiratory flow (PEF) were assessed preoperatively. Postoperative outcomes were collected until 30 days of surgery. Patients with and without complications were compared in terms of demographics, surgical details and physical activity. Receiver operating characteristic curves were used to assess the performance of physical activity as a diagnostic test in the detection of complications and prolonged length of stay (LOS) of more than 5 days.
A total of 50 patients was included. Patient groups with (n=18, 36%) and without (n=32, 64%) complications were comparable in terms of demographics and surgery, except that patients with complications were significantly older (mean age 67.1 vs 53.3 years, p=0.020). There was no difference in the mean number of preoperative footsteps, but patients with complications walked significantly less postoperatively (mean daily footsteps 1101 vs 1243, p=0.018). PEF was significantly lower in the group with complications (mean flow 294.3 vs 363.6 l/min, p=0.038) while there was no difference between groups for the other two tests (TUGT and 6MWT). Overall, the tests had no capacity to discriminate the occurrence of complications and prolonged LOS, except the 6MWT for LOS (AUC=0.746, p=0.004, CI 95%: 0.604-0.889).
Colorectal surgery patients with complications were elderly, had decreased PEF and walked less postoperatively. No physical tests allowed to discriminate patients with complications, however, the 6MWT could be used preoperatively to discriminate patients with potentially increased LOS in order to establish a prehabilitation strategy and foster postoperative mobilisation strategies.