scholarly journals Comparison of Footsteps Using Connected Bracelets with the Timed Up-and-Go Test and the 6-Minutes Walking Test in a Prospective Colorectal Surgery Cohort

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 563
Author(s):  
Benoît Romain ◽  
David Martin ◽  
Thibaut Fabacher ◽  
Basile Pache ◽  
Dieter Hahnloser ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colorectal Surgery ◽  
Prospective Study ◽  
Enhanced Recovery ◽  
Pearson Correlation ◽  
Timed Up And Go ◽  
Walking Test ◽  
Recovery Programs ◽  
Multivariable Regression ◽  
Enhanced Recovery Programs

Preoperative physical activity and early postoperative mobilization are key components of enhanced recovery programs but both difficult to assess. The aim of this prospective study was therefore to compare different ways to measure preoperative physical activity and to correlate those tests with postoperative physical activity (footsteps). The daily number of footsteps was recorded from preoperative day 5 to postoperative day (POD) 3 in a prospective cohort of colorectal patients using connected wrist bracelets. Timed Up-and-Go Test (TUGT) and 6-Minutes Walking Test (6MWT) were assessed preoperatively. Pearson correlation and multivariable regression were used to study the predictive potential of these tests for postoperative footsteps. A total of 50 patients were included. Mean number of preoperative and postoperative footsteps were 6163 (SD 4274) and 1183 (SD 1828), respectively. There was no correlation between preoperative footsteps and preoperative tests (TUGT and 6MWT) as well as between preoperative tests (TUGT and 6MWT) and postoperative footsteps. Postoperative physical activity was significantly correlated with mean number of preoperative footsteps (Rho = 0.527, IC 95 [0.28;0.709]; p < 0.001). Thereby, preoperative footsteps measurement was the only tool permitting to predict postoperative footsteps. Other preoperative tests as TUGT and 6MWT could not predict immediate postoperative physical activity.

Enhanced Recovery Programs for Colorectal Surgery and Postoperative Acute Kidney Injury: Results From a Systematic Review and Meta-Analysis of Observational Studies

2020 ◽  
pp. 000313482095484
Author(s):  
Andrés Zorrilla-Vaca ◽  
Gabriel E. Mena ◽  
Juan Cata ◽  
Ryan Healy ◽  
Michael C. Grant
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Observational Studies ◽  
Enhanced Recovery ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Conventional Care ◽  
Recovery Programs ◽  
Enhanced Recovery Programs ◽  
Postoperative Aki

Background Enhanced recovery programs (ERPs) for colorectal surgery bundle evidence-based measures to reduce complications, accelerate postoperative recovery, and improve the value of perioperative health care. Despite these successes, several recent studies have identified an association between ERPs and postoperative acute kidney injury (AKI). We conducted a systematic review and meta-analysis to determine the association between ERPs for colorectal surgery and postoperative AKI. Methodology After conducting a search of major databases (PubMed, Embase, Scopus, Google Scholar, and ScienceDirect), we conducted a meta-analysis of observational studies that reported on the association between ERPs and postoperative AKI. Results Six observational studies (n = 4765 patients) comparing ERP (n = 2140) to conventional care (n = 2625) were included. Overall, ERP patients had a significantly greater odds of developing postoperative AKI (odds ratio [OR] = 1.98, 95% confidence interval [CI] 1.31-3.00, P = .001) than those who received conventional care. There was no evidence of publication bias (Begg’s test P = 1.0, Egger’s P value = .95). Conclusions Based upon pooled results from observational studies, ERPs are associated with increased odds of developing postoperative AKI compared to conventional perioperative care. The mechanism for this effect is likely multifactorial. Additional research targeting high risk patient populations should evaluate the role of restrictive fluid administration, hemodynamic goals, and scheduled nephrotoxic agents in ERP protocols.

How does the application of surgical components in enhanced recovery programs for colorectal surgery change over time?

The Surgeon ◽  
2018 ◽  
Vol 16 (6) ◽  
pp. 321-324 ◽  
Author(s):  
Julie Veziant ◽  
Daniel Leonard ◽  
Bruno Pereira ◽  
Karem Slim ◽  
P. Alfonsi ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Change Over Time ◽  
Recovery Programs ◽  
Enhanced Recovery Programs ◽  
Over Time

scholarly journals Physical Activity and Outcomes in Colorectal Surgery: A Pilot Prospective Cohort Study

2020 ◽  
Vol 61 (1) ◽  
pp. 23-33
Author(s):  
David Martin ◽  
Benoît Romain ◽  
Basile Pache ◽  
Aurélie Vuagniaux ◽  
Valentine Guarnero ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colorectal Surgery ◽  
Prospective Cohort ◽  
Roc Curves ◽  
The Other ◽  
Mean Flow ◽  
Timed Up And Go ◽  
Walking Test ◽  
Prolonged Length ◽  
The Mean

Background: Mobilization after surgery is recommended to reduce the risk of adverse effects and to improve recovery. The aim of this study was to examine the associations between perioperative physical activity and postoperative outcomes in colorectal surgery. Methods: The daily number of footsteps was recorded from preoperative day 5 to postoperative day 3 in a prospective cohort of patients using wrist accelerometers. Timed Up and Go Test (TUGT), 6 Min Walking Test (6MWT), and peak expiratory flow (PEF) were assessed preoperatively. ROC curves were used to assess the performance of physical activity as a diagnostic test of complications and prolonged length of stay (LOS) of more than 5 days. Results: A total of 50 patients were included. Patients with complications were significantly older (67 years) than those without complications (53 years, p = 0.020). PEF was significantly lower in the group with complications (mean flow 294.3 vs. 363.6 L/min, p = 0.038) while there was no difference between groups for the other two tests (TUGT and 6MWT). The tests had no capacity to discriminate the occurrence of complications and prolonged LOS, except the 6MWT for LOS (AUC = 0.746, p = 0.004, 95% CI: 0.604–0.889). There was no difference in the mean number of preoperative footsteps, but patients with complications walked significantly less postoperatively (mean daily footsteps 1,101 vs. 1,243, p = 0.018). Conclusions:Colorectal surgery patients with complications were elderly, had decreased PEF, and walked less postoperatively. The 6MWT could be used preoperatively to discriminate patients with potentially increased LOS and foster mobilisation strategies.

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