Ying Shan, Hui Gao, Yanling Wei, Jingting Yan, Huan Chen, Tao Luo
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For the categorical analysis, a low relative amplitude group was defined as more than 2 standard deviations below the cohort mean: all other participants served as the high relative amplitude group.</p><p><strong>Main outcome measures: </strong>The primary composite outcome included 30-day postoperative complications and 90-day mortality. Multivariable logistic regression was used to adjust for comorbidities, demographics and surgical risk factors.</p><p><strong>Results: </strong>Participants with a low relative amplitude (n = 225) demonstrated significantly higher rates of adverse outcomes compared with the remainder of the participants (n = 5429), with an absolute risk difference of 6.1% (9.8 vs. 3.7%), P < 0.001). Multivariable analysis revealed a dose-response relationship: each standard deviation decrease in relative amplitude increased risk by 23% {adjusted odds ratio, aOR: 1.23 [95% confidence interval (CI), 1.06 to 1.42]}. The low amplitude group had double the risk of adverse outcomes compared with the remainder of the participants: adjusted OR: 2.16 (95% CI, 1.25 to 3.73).</p><p><strong>Conclusions: </strong>A lower preoperative circadian relative amplitude is associated with increased postoperative morbidity and mortality. Accelerometry-based circadian monitoring may provide a novel, cost-effective strategy for preoperative risk stratification.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":6.8000,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diminished rest-activity rhythm is associated with postoperative complications and mortality: A prospective cohort study of UK Biobank participants.\",\"authors\":\"Ying Shan, Hui Gao, Yanling Wei, Jingting Yan, Huan Chen, Tao Luo\",\"doi\":\"10.1097/EJA.0000000000002262\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Circadian rhythm disruption, as a modifiable risk factor, has been increasingly recognised for its potential impact on adverse health outcomes, particularly in surgical populations where its implications warrant further investigation.</p><p><strong>Objectives: </strong>To investigate associations between postoperative outcomes and preoperative rest-activity rhythm metrics from accelerometry.</p><p><strong>Design: </strong>A cohort analysis of UK Biobank participants undergoing major surgery within 1 year of accelerometer monitoring.</p><p><strong>Setting: </strong>UK Biobank, a large population-based cohort in the United Kingdom.</p><p><strong>Patients: </strong>These were 5654 adults (37 to 73 years) completing 7-day preoperative wrist accelerometry.</p><p><strong>Exposure: </strong>Rest-activity rhythm relative amplitude was analysed both as a continuous variable and as a categorical variable. For the categorical analysis, a low relative amplitude group was defined as more than 2 standard deviations below the cohort mean: all other participants served as the high relative amplitude group.</p><p><strong>Main outcome measures: </strong>The primary composite outcome included 30-day postoperative complications and 90-day mortality. Multivariable logistic regression was used to adjust for comorbidities, demographics and surgical risk factors.</p><p><strong>Results: </strong>Participants with a low relative amplitude (n = 225) demonstrated significantly higher rates of adverse outcomes compared with the remainder of the participants (n = 5429), with an absolute risk difference of 6.1% (9.8 vs. 3.7%), P < 0.001). Multivariable analysis revealed a dose-response relationship: each standard deviation decrease in relative amplitude increased risk by 23% {adjusted odds ratio, aOR: 1.23 [95% confidence interval (CI), 1.06 to 1.42]}. The low amplitude group had double the risk of adverse outcomes compared with the remainder of the participants: adjusted OR: 2.16 (95% CI, 1.25 to 3.73).</p><p><strong>Conclusions: </strong>A lower preoperative circadian relative amplitude is associated with increased postoperative morbidity and mortality. 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引用次数: 0
摘要
背景:昼夜节律紊乱作为一种可改变的危险因素,已越来越多地认识到其对不良健康结果的潜在影响,特别是在外科手术人群中,其影响值得进一步调查。目的:探讨术后预后与术前加速度计测得的休息-活动节律指标之间的关系。设计:对加速度计监测一年内接受大手术的英国生物银行参与者进行队列分析。背景:英国生物银行,一个以英国人口为基础的大型队列。患者:5654名成人(37 - 73岁)完成了7天术前腕部加速度测量。暴露:休息-活动节律相对振幅作为连续变量和分类变量进行分析。对于分类分析,低相对振幅组定义为低于队列平均值2个标准差以上:所有其他参与者均为高相对振幅组。主要结局指标:主要综合结局包括术后30天并发症和90天死亡率。采用多变量logistic回归来调整合并症、人口统计学和手术危险因素。结果:相对振幅较低的参与者(n = 225)与其余参与者(n = 5429)相比,不良结局发生率显著升高,绝对风险差异为6.1% (9.8 vs. 3.7%)。结论:较低的术前昼夜节律相对振幅与术后发病率和死亡率增加有关。基于加速度计的昼夜节律监测可能为术前风险分层提供一种新颖、经济的策略。
Diminished rest-activity rhythm is associated with postoperative complications and mortality: A prospective cohort study of UK Biobank participants.
Background: Circadian rhythm disruption, as a modifiable risk factor, has been increasingly recognised for its potential impact on adverse health outcomes, particularly in surgical populations where its implications warrant further investigation.
Objectives: To investigate associations between postoperative outcomes and preoperative rest-activity rhythm metrics from accelerometry.
Design: A cohort analysis of UK Biobank participants undergoing major surgery within 1 year of accelerometer monitoring.
Setting: UK Biobank, a large population-based cohort in the United Kingdom.
Patients: These were 5654 adults (37 to 73 years) completing 7-day preoperative wrist accelerometry.
Exposure: Rest-activity rhythm relative amplitude was analysed both as a continuous variable and as a categorical variable. For the categorical analysis, a low relative amplitude group was defined as more than 2 standard deviations below the cohort mean: all other participants served as the high relative amplitude group.
Main outcome measures: The primary composite outcome included 30-day postoperative complications and 90-day mortality. Multivariable logistic regression was used to adjust for comorbidities, demographics and surgical risk factors.
Results: Participants with a low relative amplitude (n = 225) demonstrated significantly higher rates of adverse outcomes compared with the remainder of the participants (n = 5429), with an absolute risk difference of 6.1% (9.8 vs. 3.7%), P < 0.001). Multivariable analysis revealed a dose-response relationship: each standard deviation decrease in relative amplitude increased risk by 23% {adjusted odds ratio, aOR: 1.23 [95% confidence interval (CI), 1.06 to 1.42]}. The low amplitude group had double the risk of adverse outcomes compared with the remainder of the participants: adjusted OR: 2.16 (95% CI, 1.25 to 3.73).
Conclusions: A lower preoperative circadian relative amplitude is associated with increased postoperative morbidity and mortality. Accelerometry-based circadian monitoring may provide a novel, cost-effective strategy for preoperative risk stratification.
期刊介绍:
The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).