Potential usefulness of a physical activity index in the assessment of quality of life of patients after gastrointestinal surgery.

In an attempt to evaluate a quality of life (QL) grade of patients who underwent major gastrointestinal surgery, a physical activity index (PAI) representing their daily physical activity level was introduced in the present study. The relationship between the PAI and the QL grade, which was classified into four categories (excellent, good, fair, and poor) according to our diagnostic criteria, was investigated by using postoperative patients with total gastrectomy (n = 52) and other gastrointestinal major surgery (n = 54). The PAI value was derived from basal metabolic energy expenditure and whole day energy expenditure which was predicted by a 24 hours heart rate ratio method. The evaluation of the QL was based on clinical records and answers to a questionnaire submitted to the patient. The mean PAI of the gastrectomy patients (n = 15) was lowest during the postoperative 3 months (p less than 0.005), and was then gradually restored to nearly the preoperative value during the period between the 6th and 12th months. The four graded QL groups were compared with each other in terms of the mean PAI and energy expenditure. As a result, the QL grades were proportional to both of these values, indicating that the more favourable the QL grade, the higher the PAI and the energy expenditure (p less than 0.005). These results establish that if the evaluation of energy expenditure is valid the PAI could be potentially applicable to clinical use as one of the parameters that delineate the QL grade.