CAN PREOPERATIVE PHYSICAL ACTIVITY LEVEL PREDICT POSTOPERATIVE COMPLICATIONS AFTER ABDOMINAL SURGERY?

• Grant number: 13/00814-8
• Support Opportunities: Scholarships in Brazil - Master
• Effective date (Start): June 01, 2013
• Effective date (End): March 31, 2015
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Adriana Claudia Lunardi
• Grantee: Fernando Wegner
• Host Institution: Pró-Reitoria de Pós-Graduação, Pesquisa e Extensão. Universidade Cidade de São Paulo (UNICID). São Paulo , SP, Brazil

Abstract

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 considers factors related to surgery: duration, incision site and used medications, and patient-related factors: others diseases, age, nutritional status and performance status. Studies have shown that 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; however, they have never been validated for hospitalized patients. 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 assess whether physical activity level measured by accelerometer has good correlation with physical activity measured by two validated questionnaires already (IPAQ-6 and Human Activity Profile), 3) To validate the use of accelerometer to assess physical activity level in hospitalized patients by comparison with the resting metabolic rate assessed by indirect calorimetry. Methods: This cohort study will assess the physical activity level using three tools: GTX3 Actigraph accelerometer, IPAQ-6, Human Activity Profile and indirect calorimeter in 100 consecutive candidates for elective abdominal surgery. All patients will be evaluated until 24 hours after admission. The evaluations will be enrolled medical history, habits (physical activity) and addictions (smoking history and alcoholism), pulmonary function (spirometry), respiratory muscle strength (manometer), peripheral muscle strength (handgrip strength) and resting metabolic rate (indirect calorimetry). 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. Multivariate analyzes will be used to test the predictive ability of physical activity level for postoperative complications after abdominal surgery. Association tests will verify the relationship between physical activity level assessed by accelerometer, and by IPAQ-6 and Human Activity Profile questionnaires, and by resting metabolic rate. The significance level will be adjusted at 5%

Scientific publications

(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)

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, MAY-JUN 2017. (13/00814-8, 12/16817-3)