Emelie Karlsson1, Erika Franzén2, Malin Nygren-Bonnier3, Mia Bergenmar4, Elisabeth Rydwik5. 1. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Alfred Nobels Allé 23, 23 100, 141 83 Huddinge, Sweden. Electronic address: emelie.karlsson.1@ki.se. 2. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Alfred Nobels Allé 23, 23 100, 141 83 Huddinge, Sweden; Allied Health Professionals, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Stockholms Sjukhem R&D Unit, Mariebergsgatan 22, 112 19 Stockholm, Sweden. 3. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Alfred Nobels Allé 23, 23 100, 141 83 Huddinge, Sweden; Allied Health Professionals, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden. 4. Karolinska Institutet, Department of Oncology-Pathology, 171 76 Stockholm, Sweden; Department of Upper Gastrointestinal Diseases, Karolinska University Hospital, 141 86 Stockholm, Sweden. 5. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Alfred Nobels Allé 23, 23 100, 141 83 Huddinge, Sweden; Stockholm County Council, FOU nu, Research and Development Unit for the Elderly, 177 21 Järfälla, Sweden.
Abstract
OBJECTIVES: Extensive physical deterioration as a consequence of both cancer and surgical treatment can lead to increased care needs and decreased well-being. Information on short-term physical decline and patient-reported recovery in older patients undergoing abdominal cancer surgery is still sparse. We aimed to describe the short-term changes and study the associations between preoperative physical performance and postoperative mobility, as well as patient-reported recovery in this patient group. MATERIALS AND METHODS: Patients ≥70 years of age waiting for abdominal cancer surgery were included in a prospective cohort study. Physical performance tests were conducted preoperatively and on hospital discharge. Changes from baseline to postoperative values were described, logistic regressions were performed to explore the association between preoperative physical performance and postoperative mobility, and ordinal regression for the association between physical decline and patient-reported recovery. RESULTS: One-hundred forty individuals (mean age 76.0 ± 4.6 years) were included in the analyses. We found the greatest declines in functional leg strength (38%) and walking distance (33%). Twenty participants (15%) were unable to rise from a chair without support on discharge. In the multivariable analyses, better preoperative physical performance was associated with lower odds of limited mobility on discharge. A larger decline in gait speed was associated with greater odds of reporting lower postoperative recovery. CONCLUSIONS: This study adds information regarding the magnitude of short-term physical decline and factors associated with postoperative mobility. It may be important to improve functional leg strength and physical capacity through exercise prior to abdominal cancer surgery to reduce postoperative physical decline.
OBJECTIVES: Extensive physical deterioration as a consequence of both cancer and surgical treatment can lead to increased care needs and decreased well-being. Information on short-term physical decline and patient-reported recovery in older patients undergoing abdominal cancer surgery is still sparse. We aimed to describe the short-term changes and study the associations between preoperative physical performance and postoperative mobility, as well as patient-reported recovery in this patient group. MATERIALS AND METHODS:Patients ≥70 years of age waiting for abdominal cancer surgery were included in a prospective cohort study. Physical performance tests were conducted preoperatively and on hospital discharge. Changes from baseline to postoperative values were described, logistic regressions were performed to explore the association between preoperative physical performance and postoperative mobility, and ordinal regression for the association between physical decline and patient-reported recovery. RESULTS: One-hundred forty individuals (mean age 76.0 ± 4.6 years) were included in the analyses. We found the greatest declines in functional leg strength (38%) and walking distance (33%). Twenty participants (15%) were unable to rise from a chair without support on discharge. In the multivariable analyses, better preoperative physical performance was associated with lower odds of limited mobility on discharge. A larger decline in gait speed was associated with greater odds of reporting lower postoperative recovery. CONCLUSIONS: This study adds information regarding the magnitude of short-term physical decline and factors associated with postoperative mobility. It may be important to improve functional leg strength and physical capacity through exercise prior to abdominal cancer surgery to reduce postoperative physical decline.
Authors: David Renman; Karin Strigård; Richard Palmqvist; Pia Näsvall; Ulf Gunnarsson; Anette Edin-Liljegren Journal: Cancer Control Date: 2022 Jan-Dec Impact factor: 2.339