Fit for Surgery
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Patients with low cardiorespiratory health are five times more likely to die during or just after a surgical procedure than their fitter counterparts, and on average an unfit person costs the NHS an extra £6,000 when they undergo an operation, due to longer recovery times in hospital.
Studies have identified anaerobic threshold (a measure of exercise intensity performance) as the single most significant predictor – much more accurate than age alone – of complications and mortality in surgery. To tackle this issue, for the first time ever Britain’s oldest surgical Royal College is launching a UK-wide education campaign to get patients moving in the run-up to surgery.
Data published in the Annals of Surgery demonstrates that post surgical mortality can be as high as 22% in patients with low levels of fitness, whereas patients who were fitter had only a 4% mortality rate. Many studies have also found an inverse relation between cardiorespiratory health and complications in heart, lung, colorectal and bariatric surgery.
Addressing this costly and avoidable matter, the Royal College of Surgeons of Edinburgh (www.rcsed.ac.uk); which recently opened its first-ever centre of operations in Birmingham to cater for the 80% of its membership based in England and Wales; is asking patients to speak with their surgeon or GP to work out an exercise plan that suits their condition and the type of operation they will undergo.
Consultant orthopaedic surgeon and Regional Surgical Advisor for the RCSEd Jon Dearing is unveiling the campaign - which comprises a variety of support materials including video content and an information leaflet - today at the Annual Meeting of the College’s Faculty of Sports and Exercise Medicine. He says;
“A simple 30 minutes of physical activity per day in the lead up to surgery not only can significantly reduce avoidable complications and mortality, but in some instances can even improve the chances of ‘borderline’ or unsuitable surgical candidates.
“We’re not talking necessarily about donning Lycra and getting sweaty at a gym – just straightforward measures such as walking or cycling instead of driving, taking the stairs instead of the lift and parking further away from the shops. Simple steps like this can improve surgical outcomes, aid the recovery process and even enhance the patient’s own psychological wellbeing as they get better faster. Most waiting times for surgery are around 12 weeks - this is plenty of time to work on increasing the likelihood of a successful operation.”
In April this year, the Economics of Physical Inactivity Consensus (EPIC) Conference called for a globally concerted effort to improve physical activity, which could significantly reduce the length of hospital stays and use of services as well as having long term positive health economic outcomes.
“Many people have asked me why this is the job of surgeons. My response is that it’s a healthcare issue and as good doctors it’s what we should be doing. Undergraduates are not taught about physical activity prescription, but as consultants we are expected to have all of the answers - it only takes about 30 seconds to give advice during a consultation and those are 30 seconds that could save lives and significantly reduce costs. Millions can be saved in prescription costs alone if the fitness levels of patients were improved.”
The RCSEd is committed to promoting greater awareness among patients and consultants about the benefits of physical activity before and after surgery. Support materials to be disseminated via consultants and patient groups include a short video presented by Jon Dearing and an informational leaflet, which includes a personal story from a patient encouraged to exercise as part of the recovery process following a heart attack.
According to President of the Royal College of Surgeons of Edinburgh Ian Ritchie, who is a consultant trauma and orthopaedic surgeon;
“Our job as surgeons doesn’t begin and end in the Operating Theatre. Exercise clearly helps people stave off disease and live longer – and whenever appropriate, it should become an integral part of the surgical prescription as well.
At The Royal College of Surgeons of Edinburgh we are committed to improving standards through education and training. We believe this programme will improve patient outcomes, decrease costs and above all help reduce mortality by giving us healthier patients who can bounce back quicker after a surgical intervention.”
About The Royal College of Surgeons of Edinburgh
RCSEd (www.rcsed.ac.uk) was first incorporated as the Barber Surgeons of Edinburgh in 1505, and is the oldest surgical corporation in the world with a membership of over 23,000 professionals in over 100 countries worldwide. The College promotes the highest standards of surgical and dental practice through its interest in education, training and examinations, its liaison with external medical bodies and representation of the modern surgical and dental workforce. It is also home to the UK’s only Faculty of Surgical Trainers, open to all those with an interest in surgical training regardless of College affiliation. Find RCSEd on Twitter www.twitter.com/RCSEd and on Facebook www.facebook.com/rcsed
The College is based at Nicolson Street, Edinburgh, EH8 9DW and can be reached on (0)131 527 1600 or firstname.lastname@example.org. In March 2014, a new base opened in Birmingham, catering to the 80% of the College’s UK membership who are based in England and Wales.
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