Being fit for surgery : Master Thesis - relation between preoperative fitness and perioperative outcome; feasibility and interim analysis

Atmosoerodjo, S. (Sawal) (2015) Being fit for surgery : Master Thesis - relation between preoperative fitness and perioperative outcome; feasibility and interim analysis. thesis, Medicine.

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Abstract

Introduction – While physical fitness and exercise have clear benefits on health and prevention of disease, the role of fitness in preoperative risk assessment and perioperative outcome is unknown. Recent findings have shown muscle tissue to also serve as a secretory organ with an anti-inflammatory function. In this interim analysis of a pilot study, markers for physical fitness are explored in relation to perioperative outcome, and feasibility of study execution is explored. Materials & Methods – Before surgery, baseline levels of physical activity (SQUASH questionnaire), hand grip strength, get-up-and-go-test performance, general health & quality of life (EQ-5D & RAND-36 questionnaire), anxiety & depression (HADS questionnaire), cognitive performance (CogState) and laboratory inflammatory markers were taken in cardiac patients undergoing elective coronary bypass surgery. Patients are divided in two groups based on achieval of Norm Gezond Bewegen Nederland, calculated from the SQUASH questionnaire performance. Baseline scores of questionnaires, tests, and perioperative outcome (ICU/hospital length of stay, complications) were compared between groups. Results – Of the 31 patients included, 22 were fit based on the SQUASH performance. Fit patients were stronger in the right hand than patients not fit (108% of age-matched control group vs. 91%). The get-up-and-go test revealed no difference between groups. Comorbidities were significantly more prevalent in fit patients, but baseline CRP values were significantly lower in fit patients. Questionnaire scores were mostly the same, except on domains social function and vitality of the RAND-36, in which fit patients scored significantly higher. Sample size for ICU/hospital length-of-stay and complications was too small to reliably explore (n=12 vs. n=5), but so far there is no difference in length-of-stay, but fit patients did develop more complications (50% vs. 20%) Conclusion - Measuring levels of fitness and cognition in cardiac patients undergoing elective coronary bypass surgery is well executable for both patients and researcher. The get-up-and-go test does not seem like a suited marker for general fitness. Some results so far support the anti-inflammatory role of physical activity, while others are counterintuitive, such as a higher prevalence of comorbidities in fitter patients. Continuing the study will reveal whether fitness influences perioperative outcome.

Item Type:	Thesis (Thesis)
Supervisor name:	Principal investigator: and Absalom, Prof. Dr. A.R. and Supervisor: and Huet, Dr. R.C.G. and Department of Anesthesiology, University Medical Centre Gron
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:40
Last Modified:	25 Jun 2020 10:40
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/140

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