Slow Gait Speed Is a Risk Factor for Complications After Hepatic Resection

J Gastrointest Surg. 2019 Sep;23(9):1810-1816. doi: 10.1007/s11605-018-3993-5. Epub 2018 Oct 8.

Abstract

Purpose: The aims of this study were to clarify the relationship of gait speed, hand grip strength, and skeletal muscle mass with complications after hepatic resection and to identify risk factors for complications in patients who underwent hepatic resection.

Methods: We evaluated the risk factors for complications after hepatic resection in 154 consecutive patients. Preoperative factors included gait speed, hand grip strength, and skeletal muscle mass. The gait speed and hand grip strength of patients were measured by physical therapists, and skeletal muscle mass was measured by computed tomography. Multivariate logistic regression analyses using preoperative factors were performed to assess predictors of the development of complications after hepatic resection.

Results: Thirty-three patients (21.4%) developed complications after hepatic resection. These patients had a significantly lower serum albumin level (p = 0.015), slower gait speed (p = 0.007), higher rate of hepatic resection ≥ 2 Couinaud segments (p = 0.014), and lower rate of laparoscopic hepatic resection (p = 0.017) than patients without complications. Multivariate analysis revealed that a gait speed ≤ 1.10 m/s and a serum albumin level of ≤ 4.0 g/dl were independent risk factors for complications after hepatic resection.

Conclusions: Slow gait speed and low serum albumin level are significant risk factors for complications after hepatic resection. These data will be helpful for perioperative patient management.

Keywords: Complication; Frailty; Gait speed; Hepatic resection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Hand Strength / physiology*
  • Hepatectomy / adverse effects*
  • Humans
  • Incidence
  • Japan / epidemiology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Muscle, Skeletal / physiopathology*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / physiopathology
  • Prospective Studies
  • Risk Factors
  • Walking Speed / physiology*