Routine Nutritional, Inflammatory, and Redox-Related Biomarker Abnormality Burden Is Associated with Lower 12-Week Physical Performance After Cholecystectomy in Rehabilitation Outpatients

Abstract

Simple tools for characterizing functional vulnerability after cholecystectomy are lacking, particularly among patients referred for outpatient rehabilitation. We examined whether a cumulative count of routine nutritional, inflammatory, and redox-related biomarker abnormalities at the first physical medicine and rehabilitation (PM&R) visit was associated with 12-week physical performance. This single-center retrospective cohort included 184 adults assessed 14–180 days after cholecystectomy. The exposure counted abnormalities in zinc, 25-hydroxyvitamin D, homocysteine, albumin, and neutrophil-to-lymphocyte ratio. The primary outcome was the 12-week Short Physical Performance Battery (SPPB) total score. After multivariable adjustment, each additional abnormality was associated with a 0.49-point lower 12-week SPPB score (β = −0.49, 95% confidence interval = −0.80 to −0.18; p = 0.002). Supportive analyses showed higher odds of low physical performance, lower odds of substantial SPPB improvement, lower grip strength, and a shorter 6-min walk distance. The additional explanatory value was modest (incremental R2 = 0.03). A higher routine biomarker abnormality burden may characterize postoperative vulnerability relevant to rehabilitation assessment, but the count is not a validated prediction or treatment selection tool and requires prospective validation.