The association between preoperative physical functioning and short-term postoperative outcomes: a cohort study of patients undergoing elective hepatic resection

Christel A Van Beijsterveld; Bart C Bongers; Marcel Den Dulk; Sander M J Van Kuijk; Kees C H Dejong; Nico L U Van Meeteren

doi:10.1016/j.hpb.2019.02.009

The association between preoperative physical functioning and short-term postoperative outcomes: a cohort study of patients undergoing elective hepatic resection

HPB (Oxford). 2019 Oct;21(10):1362-1370. doi: 10.1016/j.hpb.2019.02.009. Epub 2019 Mar 26.

Authors

Christel A Van Beijsterveld¹, Bart C Bongers², Marcel Den Dulk³, Sander M J Van Kuijk⁴, Kees C H Dejong⁵, Nico L U Van Meeteren⁶

Affiliations

¹ Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; Department of Physical Therapy, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, the Netherlands. Electronic address: [email protected].
² Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; SOMT University of Physiotherapy, PO Box 585, 3800 AN, Amersfoort, the Netherlands; Department of Nutrition and Movement Sciences, Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands.
³ Department of Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, the Netherlands; Department of Surgery, University Hospital RWTH-Aachen, 52074, Aachen, Germany.
⁴ Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, the Netherlands.
⁵ Department of Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, the Netherlands; Department of Surgery, University Hospital RWTH-Aachen, 52074, Aachen, Germany; Department of Surgery, Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands.
⁶ Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; Top Sector Life Sciences and Health (Health∼Holland), P.O. Box 93035, 2509 AA, The Hague, the Netherlands.

PMID: 30926327
DOI: 10.1016/j.hpb.2019.02.009

Abstract

Background: This study evaluated the association between practical performance-based indices of preoperative physical functioning and short-term postoperative outcomes in patients undergoing hepatic resection.

Method: Preoperative characteristics and results of practical performance-based tests of physical functioning were analyzed concerning the effect on postoperative outcomes (recovery of physical functioning, non-surgical complications, and length of hospital stay) using univariable and multivariable logistic regression.

Results: Perioperative data of 96 patients showed that besides the conventional risk-factors (American Society of Anesthesiologists grade III and BMI), lower absolute steep ramp test performance (in watts; OR 0.992), and lower perceived level of functional capacity to perform activities of daily living (ADL) on Duke activity status index (in metabolic equivalent of task (MET); OR 0.806) and lower score on the veterans-specific activity questionnaire (in MET, OR 0.875) were associated with delayed recovery of physical functioning. Furthermore, more comorbidities, worse functional mobility, and lower levels of perceived functional capacity to perform ADL were associated with non-surgical complications and length of hospital stay.

Conclusion: Adequate preoperative performance and perceived level of functional capacity to perform ADL appear to be of importance to identify individual patients that are at risk of a complicated postoperative course.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged
Elective Surgical Procedures / methods*
Female
Follow-Up Studies
Hepatectomy / methods*
Humans
Length of Stay / trends
Liver Diseases / physiopathology
Liver Diseases / surgery*
Male
Middle Aged
Motor Activity / physiology*
Muscle Strength / physiology*
Postoperative Period
Preoperative Period
Prognosis
Prospective Studies
Recovery of Function*