Key result
Preoperative moderate-intensity physical activity 3-4 days weekly linked to ~29% lower 90-day postoperative mortality.
Why the study?
Regular physical activity contributes to overall health and enhances resilience to surgical stress, but its association with surgical outcomes following general anesthesia required evaluation.
Does higher self-reported preoperative exercise frequency reduce postoperative mortality in adults undergoing surgery under general anesthesia?
Cohort (n=475,582)
Yes
Does higher self-reported preoperative exercise frequency reduce postoperative mortality in adults undergoing surgery under general anesthesia?
Effect estimate: HR 0.71 (95% CI 0.61-0.84)
p-value: p=< 0.001
Higher self-reported frequency of preoperative exercise is associated with reduced postoperative mortality and morbidity following general anesthesia.
PURPOSE: Regular physical activity, including structured exercise, contributes to overall health and enhances resilience to surgical stress. The aim of this study was to determine the association between the frequency of self-reported leisure-time physical activity, including moderate- o high-intensity aerobic exercise and strength training, and surgical outcomes in patients undergoing surgery under general anesthesia. METHODS: This retrospective, population-based cohort study was based on data from the National Health Insurance Service of South Korea. Adults who underwent surgery under general anesthesia between January 1 and December 31, 2021, and completed a routine national health screening questionnaire within 1 yr prior to surgery were included. The questionnaire assessed the frequency and duration of moderate- and high-intensity physical activity and strength training. RESULTS: The final analysis included 475,582 patients. Multivariable Cox regression analysis revealed that moderate-intensity physical activity performed 3-4 d·wk -1 (hazard ratio (HR), 0.71; 95% confidence interval (CI), 0.61-0.84; P < 0.001) and 5-7 d·wk -1 (HR, 0.75; 95% CI, 0.66-0.86; P < 0.001) was significantly associated with decreased 90-d postoperative mortality. Strength training 5-7 d·wk -1 was also associated with decreased 90-d mortality (HR, 0.74; 95% CI, 0.58-0.92; P < 0.001). Furthermore, moderate-intensity physical activity 1-4 h daily was associated with a 21% decrease in 90-d mortality (HR, 0.79; 95% CI, 0.71-0.89; P < 0.001). Similar findings were observed for 1-yr all-cause mortality and postoperative complications. CONCLUSIONS: A higher self-reported frequency of preoperative exercise was associated with reduced postoperative mortality and morbidity. These findings highlight the potential role of habitual physical activity in the improvement of surgical outcomes.
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Oh et al. (2025) conducted a cohort in Surgery under general anesthesia (n=475,582). Preoperative exercise (moderate-intensity physical activity or strength training) was evaluated on 90-day postoperative mortality (HR 0.71, 95% CI 0.61-0.84, p=< 0.001). Preoperative moderate-intensity physical activity 3-4 days per week was associated with decreased 90-day postoperative mortality (HR 0.71; 95% CI 0.61-0.84; P<0.001).
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