Preoperative Sedentary Time Predicts Postoperative Complications in Gastrointestinal Cancer

Abstract

Background: Gastrointestinal cancer has a high global prevalence. Postoperative complications (PCs) affect the length of hospital stay and long-term outcomes. However, it is unclear whether preoperative sedentary time is associated with PCs, independently of physical activity (PA). We aimed to investigate the association between preoperative sedentary time and PCs independently of PA in patients who underwent surgery for gastrointestinal cancer. Methods: In this prospective study, we included 112 patients who underwent colorectal cancer or gastric cancer surgery. Patient characteristics and surgery-related variables were collected. The Japanese version of the International Physical Activity Questionnaire (the usual 7-day short version) was used to assess preoperative PA and sedentary time. Patients were classified into two groups according to the grade of PCs: Clavien-Dindo (CD) grade <2 and ≥2. Multivariate logistic regression analysis was performed to identify the risk factors for CD grade ≥2 PCs. Receiver operating characteristic curve analysis was used to determine the optimal cutoff point of sedentary time for predicting PCs with CD grade ≥2. Results: PCs occurred in 38 patients (33.9%). Sedentary time (odds ratio [OR] 1.29, 95% confidence interval [CI]: 1.09–1.53; p<0.01) and body mass index (OR 1.17, 95% CI: 1.01–1.36; p=0.03) were associated with PCs independently of total PA. The optimal cutoff point of sedentary time for predicting PCs was 6 h/day (sensitivity 0.662, specificity 0.658). Conclusion: Preoperative sedentary time is a predictor of PCs in patients who undergo gastrointestinal cancer surgery.