Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Discipline of Physiotherapy, Australia.
Eur J Surg Oncol. 2019 Apr;45(4):510-518. doi: 10.1016/j.ejso.2018.10.063. Epub 2018 Oct 21.
There is uncertainty about the role of preoperative physical activity (PA) level and its influence on postoperative outcomes, especially for patients undergoing cancer surgery.
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).
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.
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).
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.
PROSPERO 2017 CRD42017082334. Available from:http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017082334.
术前体力活动（PA）水平及其对术后结果的影响尚不确定，特别是对于接受癌症手术的患者。
调查癌症手术患者术前 PA 水平是否与术后并发症发生率、住院时间（LOS）和生活质量（QOL）有关。
从 2017 年 11 月 26 日开始，对 MEDLINE、Embase、AMED 和 CINAHL 进行电子检索，纳入了研究客观或主观 PA 水平与术后并发症发生率、LOS 和 QOL 之间关系的研究。使用预后研究质量（QUIPS）工具评估偏倚风险。在可能的情况下，使用随机效应模型计算汇总比值比（OR）和 95%置信区间（CI）。
共纳入 13 项研究（5523 名患者）。总体而言，大多数研究被评为低或中度偏倚风险。较高的术前 PA 水平与术后无并发症无显著相关性（OR=2.60；95%CI=0.59 至 11.37），但与 LOS 缩短（OR=3.66；95%CI=1.38 至 9.6）和术后 QOL 改善（OR=1.29；95%CI=1.11 至 1.49）显著相关。
现有文献表明，癌症手术患者术前 PA 水平较高可能与术后结果较好相关，特别是 LOS 较短和 QOL 较高。需要高质量的研究来调查术前 PA 与术后结果之间的关系。
PROSPERO 2017 CRD42017082334。可从以下网址获取：http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017082334。
