Date of Award

2026

Degree Name

Master of Philosophy (School of Health Sciences and Physiotherapy)

Schools and Centres

Health Sciences

First Supervisor

Associate Professor Dale W Edgar

Second Supervisor

Professor Jim Codde

Third Supervisor

Dr Dana Hince

Fourth Supervisor

Dr Oscar Aldridge

Abstract

This study investigated the prevalence of modifiable preoperative lifestyle risk factors among patients undergoing upper gastrointestinal and colorectal surgery at a metropolitan hospital in Perth, Western Australia (WA). It aimed to characterise behaviours such as smoking, alcohol and drug use, nutritional risk, physical fitness, frailty, and body mass index (BMI), and to examine whether these changed during the early phase of the COVID-19 pandemic in 2020 compared to 2019.

A retrospective audit of 2,340 patient medical records was conducted, with data extracted from routinely collected preadmission documentation. Regression models compared the prevalence of risk factors across matched calendar periods, adjusting for age, sex, and surgery group. Data completeness and potential confounders were assessed to evaluate representativeness.

Literature on the indirect impacts of COVID-19 has highlighted shifts in population health behaviours, including increased alcohol and drug use and higher consumption of energy-dense foods, while smoking rates remained stable (Epidemiology Directorate, 2020). However, limited evidence has addressed these changes in surgical populations.

This study provides the first Australian evidence on how the COVID-19 pandemic influenced preoperative lifestyle behaviours. Findings revealed a distinct behavioural profile compared with broader population trends: a higher proportion of patients reported a history of smoking, alcohol and drug use remained unchanged, and nutritional risk increased markedly in 2020. These results suggest that surgical patients demonstrated both resilience and vulnerability during this period.

The findings highlight the importance of systematic preoperative screening and the integration of prehabilitation strategies into surgical pathways. Future research should link these behavioural data to postoperative outcomes to inform targeted interventions and enhance perioperative planning and system resilience during future health service disruptions.

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