A recent study led by Lancaster University has highlighted how social and environmental factors can impact a patient’s fitness levels before undergoing surgery. The research, spearheaded by Ph.D. researcher Dr. Donna Shrestha from Lancaster Medical School, sheds light on the disparities in cardiorespiratory fitness among patients from different socioeconomic backgrounds.
Published in the journal PLOS One, the study indicates that individuals from more deprived areas tend to have lower levels of cardiorespiratory fitness during preoperative assessments. This disparity in fitness levels could potentially contribute to the poorer surgical outcomes often observed in patients from disadvantaged areas. Cardiorespiratory fitness is a modifiable risk factor that can influence the success of surgical procedures, making it crucial to identify patients who may benefit from early interventions and tailored support.
The research team analyzed data from over 3,300 patients at a large NHS hospital who underwent cardiopulmonary exercise testing (CPET). CPET provides valuable insights into a patient’s cardiorespiratory fitness, helping clinicians assess surgical risks, plan prehabilitation strategies, and customize perioperative care. The results revealed that patients from deprived backgrounds were younger, had higher BMIs, and were more likely to smoke or have multiple comorbidities compared to their counterparts from more affluent areas.
Notably, cardiorespiratory fitness was significantly lower in the most deprived groups, with measures such as peak oxygen consumption (peak V̇O₂) showing considerable differences between the most and least deprived quintiles. Patients from deprived backgrounds also exhibited a higher prevalence of anaerobic threshold values below the critical threshold associated with poor surgical outcomes. Even after accounting for factors like age, sex, BMI, comorbidities, and lung function, deprivation remained a significant independent risk factor for inferior CPET results.
The study also highlighted the role of broader social determinants, including education, income, air quality, and access to green spaces, in influencing a person’s physical readiness for surgery. These factors, while contributing only modestly to variations in CPET outcomes, underscore the importance of understanding and addressing social and environmental barriers that may hinder optimal preoperative health.
Dr. Shrestha emphasized the need for tailored support pathways that consider the unique challenges faced by patients from deprived backgrounds. By addressing these social and environmental obstacles, healthcare teams can design more equitable and effective preoperative interventions that improve outcomes for all patients. The research team included experts from Lancaster Medical School, Wythenshawe Hospital, the University of Manchester, Liverpool John Moores University, and East Lancashire Hospitals NHS Trust.
For more information, the study titled “Exploring the association between socioeconomic status and cardiopulmonary exercise testing measures: A cohort study based on routinely collected data” can be accessed in PLOS One. The findings underscore the importance of addressing social disparities in healthcare to ensure fair and positive surgical outcomes for all patients.
This article was provided by Lancaster University. For more information, visit their website at www.lancs.ac.uk.
