| Title: | Diminished rest-activity rhythm is associated with postoperative complications and mortality |
| Journal: | European Journal of Anaesthesiology |
| Published: | 20 Aug 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40838705/ |
| DOI: | https://doi.org/10.1097/eja.0000000000002262 |
Publication 19716
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Abstract
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.</p>
OBJECTIVES: To investigate associations between postoperative outcomes and preoperative rest-activity rhythm metrics from accelerometry.</p>
DESIGN: A cohort analysis of UK Biobank participants undergoing major surgery within 1 year of accelerometer monitoring.</p>
SETTING: UK Biobank, a large population-based cohort in the United Kingdom.</p>
PATIENTS: These were 5654 adults (37 to 73 years) completing 7-day preoperative wrist accelerometry.</p>
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.</p>
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.</p>
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).</p>
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.</p>
17 Keywords
- Accelerometry
- Adult
- Aged
- Biological Specimen Banks
- Circadian Rhythm
- Cohort Studies
- Female
- Humans
- Male
- Middle Aged
- Mortality
- Postoperative Complications
- Prospective Studies
- Rest
- Risk Factors
- UK Biobank
- United Kingdom
6 Authors
- Ying Shan
- Hui Gao
- Yanling Wei
- Jingting Yan
- Huan Chen
- Tao Luo
1 Application
| Application ID | Title |
|---|---|
| 73684 | Identifying risk factors of complex diseases: observational and genetic associations |
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