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Can a sedentary lifestyle predict postoperative complications in patients undergoing abdominal surgery a high?

Grant number: 12/16817-3
Support Opportunities:Regular Research Grants
Duration: December 01, 2012 - November 30, 2014
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Adriana Claudia Lunardi
Grantee:Adriana Claudia Lunardi
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil


Postoperative complications after abdominal procedures are extremely common and cause prolongation of hospitalization days, increased mortality and hospital costs. The prevention of these complications should be a constant aim of the multidisciplinary team. The stratification of surgical risk of elective procedures considers factors related to surgery: duration, incision site and used medications, and patient-related factors: others diseases, age, nutritional status and performance status. It also seems that the functionality and exercise capacity are important markers of postoperative complication rate, length stay and mortality. In this sense, several functional capacity tests have been employed in goal to predict surgical risk in cardiac and thoracic surgery, but none has proved effective in abdominal surgery. The objective assessments of physical activity level and sedentary lifestyle have been increasingly developed. Accelerometers have currently use, low-cost and easy to use. They are devices able to quantify the activity intensity and energy demand. Accelerometers have been successfully used in diverse populations such as COPD, children, healthy adults and patients undergoing cardiac surgery. The evaluation of the level of physical activity has not yet been evaluated as a predictor of postoperative complication. Objectives: 1) To evaluate if the sedentary lifestyle predicts pulmonary, cardiac and thromboembolic complications in patients undergoing abdominal surgery, 2) To evaluate if physical activity level is related with the patients functionality after 30 days of surgery, 3) To analyze the impact of length of hospitalization on peripheral muscle strength and respiratory muscle strength in elderly and adults patients, with benign and malignant disease. Methods: This cohort study will assess the physical activity level using two tools: GTX3 Actigraph accelerometer and IPAQ-version 6 in 200 consecutive candidates for elective abdominal surgery. All patients will be evaluated until 24 hours after admission and one day before surgery. The evaluations will be medical history, pulmonary function, respiratory muscle strength, peripheral muscle strength and functionality. All patients will be followed during the postoperative period by physicians and physiotherapists (intervention standardized) "blinded" to the results of preoperative assessments. The postoperative pulmonary complications (atelectasis, hypoxemia and pneumonia), cardiac complications (myocardial infarction, decompensated heart failure and significant arrhythmias) and thromboembolic events (deep venous thrombosis and pulmonary embolism) will be considerate. The incidence of complications and length of stay will be recorded until discharge. After 30 days of surgery, all patients will be reassessed about functionality and mortality. Multivariate analyzes will be used to test the predictive ability of inactivity for postoperative complications of abdominal surgery. Association tests will verify the relationship between physical activity level and functionality. Analysis of variance with three factors (time: before and after hospitalization, age: adult and elderly, disease: benign and malignant) for repeated measures with post hoc Tukey test will be used to evaluate the impact of hospitalization time in these populations. The significance level will be adjusted at 5% (AU)

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Scientific publications (4)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
FONTENELE GARCIA, ISABEL FIALHO; TIUGANJI, CARINA TIEMI; MORAIS PEREIRA SIMOES, MARIA DO SOCORRO; LUNARDI, ADRIANA CLAUDIA. A study of measurement properties of the Life-Space Assessment questionnaire in older adults with chronic obstructive pulmonary disease. CLINICAL REHABILITATION, v. 32, n. 10, p. 1374-1382, . (15/12614-9, 12/16817-3)
SIMOES, MARIA DO SOCORRO M. P.; GARCIA, ISABEL F. F.; COSTA, LUCIOLA DA C. M.; LUNARDI, ADRIANA C.. Life-Space Assessment questionnaire: Novel measurement properties for Brazilian community-dwelling older adults. Geriatrics & Gerontology International, v. 18, n. 5, p. 783-789, . (12/16817-3)
FONTENELE GARCIA, ISABEL FIALHO; TIUGANJI, CARINA TIEMI; MORAIS PEREIRA SIMOES, MARIA DO SOCORRO; SANTORO, ILKA LOPES; LUNARDI, ADRIANA CLAUDIA. Systemic effects of chronic obstructive pulmonary disease in young-old adults' life-space mobility. INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, v. 12, p. 2777-2785, . (15/12614-9, 12/16817-3)
SOUZA, DANIEL C.; WEGNER, FERNANDO; COSTA, LUCIOLA C. M.; CHIAVEGATO, LUCIANA D.; LUNARDI, ADRIANA C.. Measurement properties of the Human Activity Profile questionnaire in hospitalized patients. BRAZILIAN JOURNAL OF PHYSICAL THERAPY, v. 21, n. 3, p. 153-158, . (13/00814-8, 12/16817-3)

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