Is preoperative physical activity level of patients undergoing cancer surgery associated with postoperative outcomes?: A systematic review and meta-analysis

Daniel Steffens, Paula R. Beckenkamp, Jane Young, Michael Solomon, Tatiane M. da Silva, Mark J. Hancock

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: There is uncertainty about the role of preoperative physical activity (PA) level and its influence on postoperative outcomes, especially for patients undergoing cancer surgery. Aim: To investigate if the level of preoperative PA in patients undergoing cancer surgery is associated with postoperative complication rates, length of hospital stay (LOS) and quality of life (QOL). Methods: An electronic search was performed from inception to 26th November 2017 in MEDLINE, Embase, AMED and CINAHL. Studies investigating the association between objective or subjective level of PA and postoperative complication rates, LOS and QOL were included. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. When possible, summary odds ratios (OR) and 95% confidence intervals (CI) were calculated using random-effect models. Results: 13 studies (5523 unique patients) were included. Overall, most studies were rated as having low or moderate risk of bias. Higher preoperative level of PA was not significantly associated with absence of postoperative complications (OR = 2.60; 95%CI = 0.59 to 11.37) but was significantly associated with shorter LOS (OR = 3.66; 95%CI = 1.38 to 9.6) and postoperative QOL (OR = 1.29; 95%CI = 1.11 to 1.49). Conclusions: The available literature suggests higher levels of preoperative PA in patients undergoing cancer surgery may be associated with better postoperative outcomes, particularly shorter LOS and better QOL. There is a need for high-quality studies investigating the association between preoperative PA and postoperative outcomes. Systematic review registration: PROSPERO 2017 CRD42017082334. Available from:http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017082334.

LanguageEnglish
Pages510-518
Number of pages9
JournalEuropean Journal of Surgical Oncology
Volume45
Issue number4
DOIs
Publication statusPublished - Apr 2019

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Meta-Analysis
Length of Stay
Exercise
Neoplasms
Odds Ratio
Quality of Life
Confidence Intervals
MEDLINE
Uncertainty

Cite this

Steffens, Daniel ; Beckenkamp, Paula R. ; Young, Jane ; Solomon, Michael ; da Silva, Tatiane M. ; Hancock, Mark J. / Is preoperative physical activity level of patients undergoing cancer surgery associated with postoperative outcomes? A systematic review and meta-analysis. In: European Journal of Surgical Oncology. 2019 ; Vol. 45, No. 4. pp. 510-518.
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abstract = "Background: There is uncertainty about the role of preoperative physical activity (PA) level and its influence on postoperative outcomes, especially for patients undergoing cancer surgery. Aim: To investigate if the level of preoperative PA in patients undergoing cancer surgery is associated with postoperative complication rates, length of hospital stay (LOS) and quality of life (QOL). Methods: An electronic search was performed from inception to 26th November 2017 in MEDLINE, Embase, AMED and CINAHL. Studies investigating the association between objective or subjective level of PA and postoperative complication rates, LOS and QOL were included. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. When possible, summary odds ratios (OR) and 95{\%} confidence intervals (CI) were calculated using random-effect models. Results: 13 studies (5523 unique patients) were included. Overall, most studies were rated as having low or moderate risk of bias. Higher preoperative level of PA was not significantly associated with absence of postoperative complications (OR = 2.60; 95{\%}CI = 0.59 to 11.37) but was significantly associated with shorter LOS (OR = 3.66; 95{\%}CI = 1.38 to 9.6) and postoperative QOL (OR = 1.29; 95{\%}CI = 1.11 to 1.49). Conclusions: The available literature suggests higher levels of preoperative PA in patients undergoing cancer surgery may be associated with better postoperative outcomes, particularly shorter LOS and better QOL. There is a need for high-quality studies investigating the association between preoperative PA and postoperative outcomes. Systematic review registration: PROSPERO 2017 CRD42017082334. Available from:http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017082334.",
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Is preoperative physical activity level of patients undergoing cancer surgery associated with postoperative outcomes? A systematic review and meta-analysis. / Steffens, Daniel; Beckenkamp, Paula R.; Young, Jane; Solomon, Michael; da Silva, Tatiane M.; Hancock, Mark J.

In: European Journal of Surgical Oncology, Vol. 45, No. 4, 04.2019, p. 510-518.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Is preoperative physical activity level of patients undergoing cancer surgery associated with postoperative outcomes?

T2 - European Journal of Surgical Oncology

AU - Steffens,Daniel

AU - Beckenkamp,Paula R.

AU - Young,Jane

AU - Solomon,Michael

AU - da Silva,Tatiane M.

AU - Hancock,Mark J.

PY - 2019/4

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N2 - Background: There is uncertainty about the role of preoperative physical activity (PA) level and its influence on postoperative outcomes, especially for patients undergoing cancer surgery. Aim: To investigate if the level of preoperative PA in patients undergoing cancer surgery is associated with postoperative complication rates, length of hospital stay (LOS) and quality of life (QOL). Methods: An electronic search was performed from inception to 26th November 2017 in MEDLINE, Embase, AMED and CINAHL. Studies investigating the association between objective or subjective level of PA and postoperative complication rates, LOS and QOL were included. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. When possible, summary odds ratios (OR) and 95% confidence intervals (CI) were calculated using random-effect models. Results: 13 studies (5523 unique patients) were included. Overall, most studies were rated as having low or moderate risk of bias. Higher preoperative level of PA was not significantly associated with absence of postoperative complications (OR = 2.60; 95%CI = 0.59 to 11.37) but was significantly associated with shorter LOS (OR = 3.66; 95%CI = 1.38 to 9.6) and postoperative QOL (OR = 1.29; 95%CI = 1.11 to 1.49). Conclusions: The available literature suggests higher levels of preoperative PA in patients undergoing cancer surgery may be associated with better postoperative outcomes, particularly shorter LOS and better QOL. There is a need for high-quality studies investigating the association between preoperative PA and postoperative outcomes. Systematic review registration: PROSPERO 2017 CRD42017082334. Available from:http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017082334.

AB - Background: There is uncertainty about the role of preoperative physical activity (PA) level and its influence on postoperative outcomes, especially for patients undergoing cancer surgery. Aim: To investigate if the level of preoperative PA in patients undergoing cancer surgery is associated with postoperative complication rates, length of hospital stay (LOS) and quality of life (QOL). Methods: An electronic search was performed from inception to 26th November 2017 in MEDLINE, Embase, AMED and CINAHL. Studies investigating the association between objective or subjective level of PA and postoperative complication rates, LOS and QOL were included. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. When possible, summary odds ratios (OR) and 95% confidence intervals (CI) were calculated using random-effect models. Results: 13 studies (5523 unique patients) were included. Overall, most studies were rated as having low or moderate risk of bias. Higher preoperative level of PA was not significantly associated with absence of postoperative complications (OR = 2.60; 95%CI = 0.59 to 11.37) but was significantly associated with shorter LOS (OR = 3.66; 95%CI = 1.38 to 9.6) and postoperative QOL (OR = 1.29; 95%CI = 1.11 to 1.49). Conclusions: The available literature suggests higher levels of preoperative PA in patients undergoing cancer surgery may be associated with better postoperative outcomes, particularly shorter LOS and better QOL. There is a need for high-quality studies investigating the association between preoperative PA and postoperative outcomes. Systematic review registration: PROSPERO 2017 CRD42017082334. Available from:http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017082334.

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KW - Physical activity

KW - Review

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