Preoperative Physical Activity Predicts Surgical Outcomes Following Lung Cancer Resection

Abstract

Objectives: To assess whether preoperative levels of physical activity predict the incidence of post-operative complications following anatomical lung resection. Methods: Levels of physical activity (daily steps) were measured for 15 consecutive days using pedometers in 90 consecutive patients (prior to admission). Outcomes measured were cardiac and respiratory complications, length of stay, and 30-day re-admission rate. Results: A total of 78 patients’ datasets were analysed (12 patients were excluded due to non-compliance). Based on steps performed they were divided into quartiles; 1 (low physical activity) to 4 (high physical activity). There were no significant differences in age, smoking history, COPD, BMI, percentage predicted FEV1 and KCO and cardiovascular risk factors between the groups. There were significantly fewer total complications in quartiles 3 and 4 (high physical activity) compared to quartiles 1 and 2 (low physical activity) (8 vs 22; P = .01). There was a trend ( P > .05) towards shorter hospital length of stay in quartiles 3 and 4 (median values of 4 and 5 days, respectively) compared to quartiles 1 and 2 (6 days for both groups). Conclusions: Preoperative physical activity can help to predict postoperative outcome and can be used to stratify risk of postoperative complications and to monitor impact of preoperative interventions, ultimately improving short term outcomes.

Utilization of Wearable Pedometer Devices in the Perioperative Period: A Qualitative Systematic Review

“…Preoperatively, Billé et al 13 found that the first 2 quartiles walked 7673 and 4196 steps per day respectively, while the bottom 2 quartiles recorded an average step count of 967 and 2672 steps. There was no association between preoperative step count and cancer stage, performance status, or comorbidities.…”

“…The risk of bias assessments of each study is displayed in Figure 2 and discussed in Supplemental Digital Content 1, Supplemental Material 1, pages 3-11, http://links.lww.com/AA/E174. Preoperative Step Count Preoperatively, Billé et al 13 found that the first 2 quartiles walked 7673 and 4196 steps per day respectively, while the bottom 2 quartiles recorded an average step count of 967 and 2672 steps. There was no association between preoperative step count and cancer stage, performance status, or comorbidities.…”

The Use of Wearable Devices in Oncology Patients: A Systematic Review

“…Across studies that examined the accuracy and reliability of wearable devices, results showed good convergence on the robustness of data derived from wearable technologies, especially when compared to patient- or clinician-reported data on physical activity or fitness. 21 , 40 , 45 , 147 , 173 , 194 While medical-grade wearable devices such as ActiGraph provided more sensitive and accurate measurements, consumer-grade devices such as Fitbit provided sufficient accuracy to achieve its intended purposes of objectively measuring patient physical activity. 209 Consumer-grade devices are therefore budget-friendly and viable alternatives that may be effectively utilized, 13 , 14 particularly in less resource-rich regions.…”

“… 147 In addition, wearable devices capture physical activity data in continuous, real-time, free-living settings without interrupting participants’ day-to-day. 11 , 17 , 18 , 21-23 , 25 , 40 , 44 , 45 , 51 , 62 , 63 , 66 , 76 , 83 , 85 , 86 , 89 , 90 , 92 , 104 , 108 , 111 , 112 , 119 , 122 , 126 , 128 , 129 , 136 , 139 , 142 , 143 , 147 , 157 , 158 , 161 , 163 , 166 , 172 , 173 , 176-178 , 181 , 188 , 192 , 194 , 208 Of the studies that reported on the adherence of wearable devices, 43 (70%) of them cited high adherence at greater than 80%. Additionally, feasibility studies generally noted positive experience/satisfaction using wearable devices, citing ease of use, comfort, usefulness, and no interference with daily activity related to Fitbits, ActivPal, and Biovotion AG devices.…”

Association of Daily Step Count and Postoperative Surgical Complications Among All of Us Research Participants

“…Recently, several studies have examined the association of preoperative step counts recorded by wearable pedometer devices with postoperative outcomes. [12][13][14][15] However, prior work has typically been confined to small prospective cohorts undergoing a single type of procedure. In addition, no study utilizing a large-scale EHR dataset has measured the association between step counts and postoperative outcomes across procedures of varying organ sites and complexity.…”