Self-Reported Preoperative Exercise Frequency and Surgical Outcomes Following General Anesthesia: A Nationwide Cohort Study.

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 year 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 days per week (hazard ratio [HR]: 0.71; 95% confidence interval [CI]: 0.61, 0.84; P < 0.001) and 5-7 days per week (HR: 0.75; 95% CI: 0.66, 0.86; P < 0.001) was significantly associated with decreased 90-day postoperative mortality. Strength training 5-7 days per week was also associated with decreased 90-day mortality (HR: 0.74; 95% CI: 0.58, 0.92; P < 0.001). Furthermore, moderate-intensity physical activity 1-4 hours daily was associated with a 21% decrease in 90-day mortality (HR: 0.79; 95% CI: 0.71, 0.89; P < 0.001). Similar findings were observed for 1-year 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.