The association between preoperative physical functioning and short-term postoperative outcomes: a cohort study of patients undergoing elective hepatic resection

Background: This study evaluated the association between practical performance-based indices of preoperative physical functioning and short-term postoperative outcomes in patients undergoing hepatic resection. Method: Preoperative characteristics and results of practical performance-based tests of physical functioning were analyzed concerning the effect on postoperative outcomes (recovery of physical functioning, non-surgical complications, and length of hospital stay) using univariable and multivariable logistic regression. Results: Perioperative data of 96 patients showed that besides the conventional risk-factors (American Society of Anesthesiologists grade III and BMI), lower absolute steep ramp test performance (in watts; OR 0.992), and lower perceived level of functional capacity to perform activities of daily living (ADL) on Duke activity status index (in metabolic equivalent of task (MET); OR 0.806) and lower score on the veterans-specific activity questionnaire (in MET, OR 0.875) were associated with delayed recovery of physical functioning. Furthermore, more comorbidities, worse functional mobility, and lower levels of perceived functional capacity to perform ADL were associated with non-surgical complications and length of hospital stay. Conclusion: Adequate preoperative performance and perceived level of functional capacity to perform ADL appear to be of importance to identify individual patients that are at risk of a complicated postoperative course.