Department of Anesthesiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Department of Cardiothoracic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
PLoS One. 2020 Oct 13;15(10):e0240128. doi: 10.1371/journal.pone.0240128. eCollection 2020.
Physical inactivity and a sedentary lifestyle are associated with a chronic low-level inflammatory state which has been implicated in the pathogenesis of cardiovascular disease. There is growing interest in exercise programs as part of surgical 'prehabilitation'. We therefore studied preoperative physical activity levels of patients undergoing elective Coronary Artery Bypass Graft (CABG) surgery, and performed an exploratory analysis of the influence of physical activity on postoperative outcome. The Short Questionnaire to Assess Health (SQUASH) was used to assess physical activity among 100 patients, of mean (SD) age 65.4 (7.6) years. Additionally, handgrip strength was measured, and the get-up-and-go test was conducted. Anxiety, depression, and quality of life were assessed, and a computerised cognitive test battery was used to assess cognitive performance preoperatively, and three months after surgery. Preoperatively, 76% of patients met the recommended national guidelines for physical activity. The incidence of pre-existing medical conditions, and other pre-operative patient features were similar in active and inactive patients. Preoperative physical activity was significantly inversely related to the logistic EuroSCORE. The level of physical activity was also significantly inversely related with preoperative C-reactive protein (CRP) and peak postoperative CRP, but physical activity did not appear to be associated with any adverse postoperative outcomes or extended length of hospital stay. The incidence of postoperative neurocognitive disorder (PNCD) at 3 months postoperatively was 26%. Cognitive performance was not related with physical activity levels. In summary, this was the first study to assess activity levels of cardiac surgical patients with the SQUASH questionnaire. The majority of patients were physically active. Although physical activity was associated with lower levels of inflammation in this pilot study, it was not associated with an improved clinical or cognitive postoperative outcome.
身体活动不足和久坐的生活方式与慢性低度炎症状态有关，这种状态与心血管疾病的发病机制有关。人们对作为外科“预康复”一部分的运动方案越来越感兴趣。因此，我们研究了择期冠状动脉旁路移植术 (CABG) 患者的术前身体活动水平，并对身体活动对术后结果的影响进行了探索性分析。使用简短健康问卷 (SQUASH) 评估了 100 名平均 (SD) 年龄 65.4 (7.6) 岁的患者的身体活动水平。此外，还测量了手握力，并进行了起身行走测试。评估了焦虑、抑郁和生活质量，并使用计算机认知测试电池在术前和术后三个月评估认知表现。术前，76%的患者符合国家推荐的身体活动指南。活跃患者和不活跃患者的现有医疗条件和其他术前患者特征相似。术前身体活动与逻辑 EuroSCORE 呈显著负相关。身体活动水平也与术前 C 反应蛋白 (CRP) 和术后高峰 CRP 呈显著负相关，但身体活动似乎与任何不良术后结果或延长住院时间无关。术后 3 个月的术后神经认知障碍 (PNCD)发生率为 26%。认知表现与身体活动水平无关。总之，这是第一项使用 SQUASH 问卷评估心脏外科患者活动水平的研究。大多数患者身体活跃。尽管在这项初步研究中，身体活动与较低水平的炎症有关，但它与改善的临床或认知术后结果无关。
