AIM: Changes in postoperative fatigue, physical function and body composition were described in patients after open colorectal surgery, and factors that predicted postoperative fatigue 1 month after surgery were identified. METHOD: Data from five clinical intervention studies from 1991 to 2005 were amalgamated. Patients (n = 385) were examined preoperatively, at discharge and 1 month postoperatively. The level of fatigue was scored subjectively from 1 'fit' to 10 'fatigued' on a modified visual analogue scale and by objective measurements of hand grip and knee extension strength, work capacity, weight, lean body mass and fat mass. A logistic regression analysis was used to identify the predictors of a high fatigue score 1 month postoperatively. RESULTS: Preoperatively, only 17% had a high fatigue score (≥ 5.5), whereas 65 and 30% had a high fatigue score at discharge and 1 month postoperatively, respectively. Postoperatively, there was a significant fall in physical performance, weight, lean body mass and fat mass that did not normalize by 1 month. High preoperative and discharge fatigue scores, major complications and the loss of lean body mass significantly increased the risk of fatigue 1 month postoperatively. CONCLUSION: Open colorectal surgery was associated with a significant increase in postoperative fatigue and a decline in physical performance, weight and lean body mass. Major complications, a high perioperative fatigue score and the loss of lean body mass increased the risk of long-term fatigue.
AIM: Changes in postoperative fatigue, physical function and body composition were described in patients after open colorectal surgery, and factors that predicted postoperative fatigue 1 month after surgery were identified. METHOD: Data from five clinical intervention studies from 1991 to 2005 were amalgamated. Patients (n = 385) were examined preoperatively, at discharge and 1 month postoperatively. The level of fatigue was scored subjectively from 1 'fit' to 10 'fatigued' on a modified visual analogue scale and by objective measurements of hand grip and knee extension strength, work capacity, weight, lean body mass and fat mass. A logistic regression analysis was used to identify the predictors of a high fatigue score 1 month postoperatively. RESULTS: Preoperatively, only 17% had a high fatigue score (≥ 5.5), whereas 65 and 30% had a high fatigue score at discharge and 1 month postoperatively, respectively. Postoperatively, there was a significant fall in physical performance, weight, lean body mass and fat mass that did not normalize by 1 month. High preoperative and discharge fatigue scores, major complications and the loss of lean body mass significantly increased the risk of fatigue 1 month postoperatively. CONCLUSION: Open colorectal surgery was associated with a significant increase in postoperative fatigue and a decline in physical performance, weight and lean body mass. Major complications, a high perioperative fatigue score and the loss of lean body mass increased the risk of long-term fatigue.
Authors: U O Gustafsson; M J Scott; W Schwenk; N Demartines; D Roulin; N Francis; C E McNaught; J Macfie; A S Liberman; M Soop; A Hill; R H Kennedy; D N Lobo; K Fearon; O Ljungqvist Journal: World J Surg Date: 2013-02 Impact factor: 3.352
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