Research ArticleResearchPatient EducationQuality Improvement

Perioperative exercise showed a small fatigue signal after colorectal-cancer surgery

Cancer medicine (PubMed)Aug 1, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

An exploratory secondary analysis of a 518-patient randomized trial found a small signal of less self-reported fatigue after colorectal-cancer surgery with unsupervised moderate exercise before and after surgery, while quality of life, pain, and mental recovery did not differ.

What NurseJet pulled from the source

The intervention added WHO-guideline moderate activity for two weeks before and four weeks after surgery. The intention-to-treat fatigue difference at four weeks was 3.75 points with a confidence interval from 0.01 to 7.49 and P value of 0.05, so the authors describe the finding as suggestive and call for further study.

Why this matters for nurses

Oncology and surgical nurses assess fatigue, function, symptoms, readiness for activity, and recovery goals before and after colorectal-cancer surgery. The study supports asking about movement and recovery planning while keeping expectations proportionate to an exploratory, marginal finding.

Bedside takeaway

Assess fatigue and mobility, then reinforce only the approved perioperative activity plan with symptom-based pause and escalation guidance.

How This Applies in Practice

Use this when: Preparing or following up with a patient who has an approved activity plan around colorectal-cancer surgery.

On your shift

Document baseline mobility, fatigue, pain, nutrition, fall risk, comorbidities, and practical barriers before reinforcing the activity plan.
Use teach-back for the prescribed activity progression, recovery goals, and symptoms that require pausing activity or contacting the care team.
Trend fatigue and function across follow-up and route worsening or unexpected symptoms for clinical evaluation rather than assuming deconditioning alone.

Keep in mind: The fatigue finding was exploratory and does not define an exercise prescription for every surgical patient. Follow the oncology protocol, facility policy, and provider orders.

Key takeaways

The secondary analysis included 518 patients from the multicenter randomized PHYSSURG-C trial.
The intervention used additional unsupervised moderate physical activity for two weeks before and four weeks after colorectal-cancer surgery.
The four-week intention-to-treat fatigue difference was 3.75 points, with a 95% confidence interval from 0.01 to 7.49.
Quality of life, pain, and mental recovery did not differ, and the fatigue analysis was post hoc and exploratory.

Practice implications

Assess baseline mobility, fatigue, symptoms, fall risk, nutrition, and barriers to the ordered activity plan. Reinforce the approved progression and stop or escalate for concerning symptoms rather than prescribing an unsupervised exercise dose from this study.

Limitations & cautions

Fatigue was a post hoc secondary outcome measured with trial-specific self-report questionnaires, the intervention was unsupervised, and the four-week intention-to-treat result was marginal at P=0.05. The study does not establish clinical importance, the best activity dose, or safety and benefit for patients outside the trial's surgical population.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Cancer medicine (PubMed)

Cancer medicine (PubMed). Effects of Prehabilitation by Physical Activity on Fatigue After Surgery for Colorectal Cancer. Results From Secondary Analyses in the Randomized Controlled Trial PHYSSURG-C.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42568293/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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A single-center retrospective cohort found that approximately one quarter of laboratory-defined acute kidney injury cases on internal medicine wards were not documented, particularly when maximal creatinine was lower.

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Among 161 adult hospitalizations meeting serum-creatinine criteria for acute kidney injury, 39 cases (24.2%) were undocumented. Length of stay and in-hospital mortality did not differ significantly by documentation status.

Key takeaways

In the 149 hospitalizations with a demonstrable creatinine change, 33 cases (22.1%) were undocumented.
Higher maximal creatinine was associated with lower adjusted odds of underdocumentation.
The study did not test whether a detection or documentation intervention improves care or outcomes.

Why this matters on shift

A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

Trend ordered renal-function results and communicate clinically important changes through the care team according to local escalation and documentation workflows.

Limitations & cautions

Abstract-only summary. This was a retrospective, single-center study of 161 hospitalizations; urine-output criteria and reliable preadmission creatinine values were unavailable, and the reference creatinine method may affect case classification.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Renal failure (PubMed). Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

European heart journal (PubMed)Sep 6, 2026Research Article

In the pragmatic TARGET-D randomized trial, vitamin D dosing titrated to a serum target did not significantly reduce the composite of death, recurrent myocardial infarction, heart-failure hospitalization, or stroke after myocardial infarction.

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Among 630 participants followed for an average of 4.2 years, major cardiovascular events occurred in 15.7% with targeted vitamin D management and 18.4% with usual care (hazard ratio 0.85, 95% CI 0.58 to 1.24; P=0.40).

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At baseline, 87% of participants had a 25-hydroxyvitamin D level of 40 ng/mL or lower.
The primary composite outcome and the individual outcomes of death, heart-failure hospitalization, and stroke were not significantly different.
A lower recurrent-MI rate was a secondary finding and should not override the nonsignificant primary result.

Why this matters on shift

The trial cautions against presenting targeted vitamin D supplementation as a proven strategy for reducing major cardiovascular events after myocardial infarction.

Bedside takeaway

Present vitamin D as prescribed supplementation, not as a replacement for established post-MI secondary prevention.

Nursing implications

Reinforce the prescribed secondary-prevention plan and avoid implying that vitamin D replaces therapies with established post-MI benefit.

Limitations & cautions

Abstract-only summary. The trial included 630 participants, 78.1% were men, the primary confidence interval included benefit and no benefit, and individual secondary outcomes were not the primary endpoint.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European heart journal (PubMed). Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

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A small randomized trial found larger one-month reductions in reported supportive-care needs among colorectal cancer caregivers who received smartphone-based education than with routine care.

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Eighty family caregivers at two teaching hospitals in Tehran were randomized. Compared with routine care, the intervention group reported larger reductions in total needs and in health-service, psychological-emotional, work-social, and information domains after four weeks.

Key takeaways

The intervention was designed around family caregivers' supportive-care needs.
All four measured need domains favored the smartphone-education group at four weeks.
The abstract reports statistical significance but does not provide effect sizes or describe the educational content in detail.

Why this matters on shift

Caregiver education is part of oncology care, and mobile delivery may extend structured support beyond brief in-person teaching encounters.

Bedside takeaway

Ask caregivers about unmet information and support needs, then reinforce teaching with approved digital resources.

Nursing implications

Assess what caregivers still need to know and use approved digital education as a supplement to individualized teaching and follow-up.

Limitations & cautions

Abstract-only summary. The trial included 80 caregivers at two hospitals, assessed self-reported needs after only four weeks, and did not report patient outcomes or effect sizes in the abstract.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Supportive care in cancer (PubMed). The effect of a smartphone-based educational intervention on the supportive care needs of family caregivers of patients with colorectal cancer: a randomized controlled trial.

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AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

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