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Self-assessed preoperative level of habitual physical activity predicted postoperative complications after colorectal cancer surgery: A prospective observational cohort study

Journal article
Authors Aron Onerup
Eva Angenete
Pierre Bonfre
Mats Börjesson
Eva Haglind
Catrin Wessman
Hanna Nilsson
Published in European Journal of Surgical Oncology
Volume 45
Issue 11
Pages 2045-2051
ISSN 0748-7983
Publication year 2019
Published at Institute of Clinical Sciences, Department of Surgery
Institute of Neuroscience and Physiology, Department of Physiology
Department of Food and Nutrition, and Sport Science
Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
Pages 2045-2051
Language en
Keywords Colon cancer, Colorectal surgery, Physical activity, Postoperative complications, Rectal cancer
Subject categories Cancer and Oncology, Surgery


Introduction: There is a growing interest in physical activity in relation to recovery after surgery. One important aspect of measuring recovery after surgical procedures is postoperative complications. The aim of this study was to determine if there is an association between the preoperative level of habitual physical activity and postoperative complications in patients undergoing elective surgery for colorectal cancer. Materials and methods: 115 patients scheduled for elective surgery due to colorectal cancer between February 2014 and September 2015 answered a questionnaire regarding physical activity and other baseline variables. Physical activity was assessed using the Saltin-Grimby physical activity level scale. Complications within 30 days after surgery were classified according to Clavien-Dindo, and the Comprehensive Complications Index (CCI) was calculated. Primary outcome was difference in CCI and key secondary outcome was risk for CCI ≥20. Results: Physically inactive individuals had a CCI that was 12 points higher than individuals with light activity (p = 0.002) and 17 points higher than regularly active individuals (p = 0.0004). Inactive individuals had a relative risk for a CCI ≥20 that was 65% higher than for individuals reporting light activity (95% confidence interval (CI) for relative risk (RR) = 1.1–2.5) and 338% higher than for regularly active individuals (95% CI for RR = 2.1–9.4). Conclusion: Self-assessed level of habitual physical activity before colorectal cancer surgery was associated with fewer postoperative complications measured with CCI, in a dose-response relationship. © 2019

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