Preoperative frailty was associated with lower daily step counts (<4137 steps/day), but the percentage of daily steps recovered at 28 days did not differ between groups (72.57% overall).
Observational (n=109)
No
Is preoperative frailty associated with lower daily step counts and impaired one-month ambulation recovery in older adults undergoing major elective operations?
In older Veterans undergoing major surgery, preoperative frailty is associated with a baseline step count of <4137 steps/day, though 28-day ambulation recovery rates are similar regardless of frailty status.
Background/Objectives: Frailty is an under-recognized preoperative risk factor for poor surgical outcomes. Recovery of preoperative ambulation levels one month after surgery represents an important patient-centered outcome. The purpose of this study was to (1) identify a preoperative daily step count threshold associated with frailty, and (2) characterize the one-month ambulation recovery (steps/day) of older adults (≥60 years) with and without frailty following major elective inpatient operations. Methods: This single-center observational pilot study included older adults undergoing elective inpatient operations at a Veterans Affairs Hospital. Frailty was assessed before surgery. Ambulation (steps/day) was measured continuously from ≥3 full days before surgery, to at least 28 days after surgery, using a wrist-worn accelerometer. Sensitivity analysis identified a step count threshold associated with frailty. The primary outcome was the percentage of daily steps recovered at 28 days. Results: The average age of participants (n = 109) was 69 years, and 37.6% (41/109) were identified as prefrail or frail. Preoperative steps/day were lower in the frail cohort (3322.00 2654.70, 5483.20 versus 4993.95 3540.90, 6599.97, p < 0.05). Sensitivity analysis showed 4137 steps/day to be associated with preoperative frailty, and this remained significant in multivariate analysis. At 28 days, the percentage of daily steps recovered did not differ between groups (72.57% 49.15, 92.06 overall). Conclusions: Preoperative frailty is associated with lower daily step counts (<4137 steps/day), identifying individuals at increased likelihood of frailty in this older Veteran cohort undergoing major surgery. The median daily step count, regardless of frailty status, was <5000 steps/day, consistent with a sedentary lifestyle, and likely too low to show a difference in one-month ambulation recovery. This finding underscores the need to explore walking interventions in older Veterans awaiting surgery.
Rove et al. (Thu,) conducted a observational in Older adults undergoing elective inpatient operations (n=109). Preoperative frailty vs. Without frailty was evaluated on Percentage of daily steps recovered at 28 days. Preoperative frailty was associated with lower daily step counts (<4137 steps/day), but the percentage of daily steps recovered at 28 days did not differ between groups (72.57% overall).