Postoperative changes in fatigue, physical function and body composition: an analysis of the amalgamated data from five randomized trials on patients undergoing colorectal surgery

Colorectal Dis. 2011 May;13(5):588-93. doi: 10.1111/j.1463-1318.2010.02232.x.

Abstract

Aim: Changes in postoperative fatigue, physical function and body composition were described in patients after open colorectal surgery, and factors that predicted postoperative fatigue 1 month after surgery were identified.

Method: Data from five clinical intervention studies from 1991 to 2005 were amalgamated. Patients (n = 385) were examined preoperatively, at discharge and 1 month postoperatively. The level of fatigue was scored subjectively from 1 'fit' to 10 'fatigued' on a modified visual analogue scale and by objective measurements of hand grip and knee extension strength, work capacity, weight, lean body mass and fat mass. A logistic regression analysis was used to identify the predictors of a high fatigue score 1 month postoperatively.

Results: Preoperatively, only 17% had a high fatigue score (≥ 5.5), whereas 65 and 30% had a high fatigue score at discharge and 1 month postoperatively, respectively. Postoperatively, there was a significant fall in physical performance, weight, lean body mass and fat mass that did not normalize by 1 month. High preoperative and discharge fatigue scores, major complications and the loss of lean body mass significantly increased the risk of fatigue 1 month postoperatively.

Conclusion: Open colorectal surgery was associated with a significant increase in postoperative fatigue and a decline in physical performance, weight and lean body mass. Major complications, a high perioperative fatigue score and the loss of lean body mass increased the risk of long-term fatigue.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Body Composition / physiology*
  • Body Mass Index
  • Colorectal Neoplasms / surgery*
  • Exercise Tolerance / physiology*
  • Fatigue / etiology*
  • Fatigue / physiopathology
  • Female
  • Hand Strength
  • Hemoglobins / metabolism
  • Hemoglobins / physiology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Postoperative Complications / physiopathology*
  • Postoperative Period
  • Serum Albumin / metabolism
  • Serum Albumin / physiology

Substances

  • Hemoglobins
  • Serum Albumin