Physical Activity and the Enhanced Recovery After Surgery Program in Cystectomy Patients
Primary Investigator: Amber Patel, BSN, RN, CNOR
Purpose: The Enhanced Recovery After Surgery (ERAS) program is a multimodality concept aimed at improving surgical outcomes. The ERAS program currently lacks structured guidelines for preoperative exercise. The purpose of this project is to determine the relationship between self-reported level of physical activity and surgical outcomes in patients who have undergone cystectomy with and without ERAS.
Methods: A de-identified data set of patients who underwent radical cystectomy was compiled (N=124). The sample included patients from before and after the initiation of a the ERAS program. Demographics, self-reported physical activity, and surgical outcomes were collected. Levels of physical activity were categorized as low, moderate, or high based on the International Physical Activity Questionnaire (IPAQ) scoring.
Results: Demographic characteristics, similar between ERAS and no ERAS groups. For ERAS length of stay (LOS) was significantly shorter for patients reporting moderate physical activity levels versus low activity levels (6.2 compared to 8.1 days, p = .009). LOS was also shorter in the moderate activity group versus the low activity group in the no ERAS cohort (7.2 vs. 10.9 days, p = .036). Complications in 30 days were lower in the ERAS cohort for the moderate activity versus the low activity group (20.5 vs. 45%, p = .041). There was no difference between moderate and low activity groups in the no ERAS cohort (33 vs. 52%, p = .153).
Discussion: These results indicate that higher levels of physical activity may influence surgical outcomes after radical cystectomy to a greater extent when the ERAS is used.
Conclusions: Incorporating a structured preoperative exercise protocol into the ERAS program may improve surgical outcomes in patients undergoing radical cystectomy.
Major Professor: James Whyte, ND, PhD, FNAP, FAAN