A Abeles, BSc, MBBS, MRCS, R M Kwasnicki, BSc, MBBS, PhD, L Geoghegan, P Pratt, BSc, PhD, A Darzi, KBE, PC, FRCS, FRS, FMedSci. Imperial College London
Introduction: Physical activity is an important component of enhanced recovery (ERAS) in the peri-operative period, but may have further utility than currently known. Advances in technology have made way for small, light-weight, body worn sensors that can objectively monitor physical activity outside of the laboratory setting. The aim of this study is to quantify patient activity levels pre and post-operatively and correlate these with patient outcomes.
Methods: Thirty-four patients undergoing elective colorectal surgical procedures were recruited. Patients used a wrist-worn activity monitor (AX3, Axivity, Newcastle, UK) pre-operatively at home and post-operatively on the ward until discharge. Activity levels were recorded and presented as time (mins) spent in light, moderate or vigorous activity. Patient demographics and clinical details were also collected. Associations between activity levels and patient outcomes were assessed using SPSS Statistics (v23, IBM Corp, Armonk, NY).
Results: A statistically significant negative correlation was found between physical activity on post-operative day one and length of hospital stay (rs = -0.466, p = 0.02). A positive correlation was found between activity levels on post-operative day one and activity levels on post-operative days two to five (rs 0.491 – 0.811, p <0.05). Activity levels on post-operative days two to six also negatively correlated with hospital length of stay (rs -0.467 – -0.681, p <0.05). The mean percentage return to baseline activity on the last full day before discharge was 30% (SD 26%). There was no significant correlation between pre-operative activity levels and length of stay (rs = -0.323, p = 0.107).
Conclusion: This study quantifies the fractional return to baseline activity levels at the time of discharge, suggesting that much of recovery occurs in the community setting. There is also a moderate negative correlation between post-operative activity and hospital length of stay. This may act as a useful predictor of patient outcomes and enables extra support and clinical input to be given to optimise recovery. Although no significant correlation was found between pre-operative activity levels and length of stay, a predictive model may be feasible through further consideration and adjustment based on patient and operation variables.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78796
Program Number: P429
Presentation Session: Poster (Non CME)
Presentation Type: Poster
