Perioperative medicine & outcomes
Impact of Preoperative Functional Capacity on Postoperative Mortality and Morbidity: A Prospective Cohort Study
Authors' conclusion
Self-reported functional capacity, categorized by MET levels, is associated with both short- and long-term postoperative mortality and morbidity in a dose-response-like manner.
Study context
- Population
- Adults undergoing elective noncardiac surgery at Karolinska University Hospital (Solna and Huddinge, Sweden), 2020–2023; obstetric, transplant, day surgery and nonoperative cases excluded
- Participants
- 38,293 adults
- Exposure
- Preoperative metabolic equivalents of task (MET) categories vs MET 9 or greater
- Outcome
- All-cause mortality at 30 and 365 days
- Follow-up
- 30 and 365 days
Methodological detailsdual-centre
- Dual-centre
Main finding
As reported in the abstract
365-day mortality · 365 days
Each group vs MET 9 or greaterAdjusted marginal absolute risk difference (95% CI)
MET 6 to 8
0.8%(0.1–1.5)
MET 4 to 5
2.3%(1.6–2.90)
MET 2 to 3
3.8%(2.91–4.6)
MET 1
7.2%(5.2–9.8)
Relative median survival time
- MET 6 to 8 · adjusted accelerated failure time model
- 0.75 (95% CI 0.56–0.98)
- MET 4 to 5 · adjusted accelerated failure time model
- 0.52 (95% CI 0.40–0.68)
- MET 2 to 3 · adjusted accelerated failure time model
- 0.39 (95% CI 0.29–0.51)
- MET 1 · adjusted accelerated failure time model
- 0.24 (95% CI 0.16–0.34)
- Overall 30-day mortality
- 220 (0.6%)
- Overall 365-day mortality
- 2061 (5.4%)
Observational data: associations, not effects.
Secondary outcomes
DAH365 · 365 days
- Lower MET levels associated with fewer DAH365, particularly in the lower quantiles
Original publication
Impact of Preoperative Functional Capacity on Postoperative Mortality and Morbidity: A Prospective Cohort Study. Anesthesiology. Published 3 October 2025. doi:10.
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