Preoperative physical activity and functional performance levels are predictors of acute postoperative outcomes in a private South African colorectal cancer cohort.
Megan Whelan, Heleen van Aswegen, Ronel Roos and 2 others
PMID 34355106WHAT IT FOUND
In this colorectal surgery cohort, patients with lower preoperative vigorous activity stayed in hospital longer, and those with poorer functional performance had more postoperative complications.
Screening these two factors before surgery may help identify patients at higher risk for a difficult recovery.
Key findings
01Low weekly vigorous-intensity physical activity was a significant predictor of increased hospital length of stay.
02High ECOG scores (indicating poorer functional performance) were a significant predictor of the development of postoperative complications.
03Surgical site infection and ileus were the most frequent postoperative complications, occurring in 42.5% and 25.7% of the complication group respectively.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was retrospective and relied on an existing database not originally designed for these specific predictive questions. There was a substantial amount of missing data, particularly for ECOG scores (24.8% missing) and ASA scores (39.2% missing), which limits the reliability of the conclusions. Moderate-intensity physical activity data were missing due to a data collection error, so only vigorous activity was analysed. The sample was small (n=125) and drawn from a private urban centre, so results may not apply to public sector or rural populations. The study could not confirm causality between the predictors and outcomes due to its design. Sarcopenia, a known risk factor, was not measured in this cohort.
Declared interests
The study was part of a larger cohort funded by the South African Medical Research Council. The authors declared no other conflicts of interest.
The easy way to misread this
Do not interpret the association between low vigorous activity and longer hospital stays as proof that prescribing exercise will definitely shorten stays. This was an observational study with missing data and no control group, so it identifies risk markers rather than testing the efficacy of an intervention.