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July 8, 2021Cochrane libraryOpen Access

Prehabilitation exercise therapy before elective abdominal aortic aneurysm repair

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Key result

Prehabilitation exercise therapy before elective abdominal aortic aneurysm repair showed uncertain effects on 30-day mortality compared to usual care (RR 1.33; 95% CI 0.31 to 5.77).

Why the study?

Studies evaluating preoperative exercise interventions for people waiting for AAA repair have reported conflicting results.

Does prehabilitation exercise therapy reduce perioperative and postoperative morbidity and mortality in patients awaiting elective abdominal aortic aneurysm repair?

Population

232 participants with clinically diagnosed AAA deemed suitable for elective intervention across 4 RCTs

Comparison

Prehabilitation exercise therapy vs usual care (no exercise)

Design

Systematic review and meta-analysis of RCTs

Authors

CFCandida FentonATAudrey R TanUAUkachukwu Okoroafor Abaraogu

Discussion

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Overview

Uncertain mortality effects advise against routine adoption; leaves open potential complication benefits pending higher-certainty trials.

Study Design

Type

Systematic Review (n=232)

Structured PICO

Does prehabilitation exercise therapy reduce perioperative and postoperative morbidity and mortality in patients awaiting elective abdominal aortic aneurysm repair?

P
Population
232 participants with clinically diagnosed abdominal aortic aneurysm suitable for elective intervention across 4 randomized controlled trials.
I
Intervention
Prehabilitation exercise therapy (3 to 6 sessions per week, 1 hour per session, for 1 to 6 weeks; including circuit training, moderate-intensity continuous exercise, and high-intensity interval training).
C
Comparator
Usual care (no exercise; participants maintained normal physical activity).
O
Outcome
Post-AAA repair mortality (30-day or longer) and perioperative/postoperative complications.hard clinical

Main Result

Relative Risk: 1.33 (95% CI 0.31–5.77)

Prehabilitation exercise therapy before elective AAA repair may reduce cardiac and renal complications, but the evidence is of low certainty and its effect on mortality remains uncertain.

Limitations

  • All included trials were at a high risk of bias
  • Small sample sizes leading to imprecision
  • Low to very low certainty of evidence
  • High risk of bias in all included trials
  • Small sample sizes (imprecision)

Cite This Study

Fenton et al. (2021) conducted a systematic review in Abdominal aortic aneurysm (AAA) (n=232). Prehabilitation exercise therapy vs. Usual care (no exercise) was evaluated on 30-day mortality post-AAA repair (RR 1.33, 95% CI 0.31 to 5.77). Prehabilitation exercise therapy before elective abdominal aortic aneurysm repair showed uncertain effects on 30-day mortality compared to usual care (RR 1.33; 95% CI 0.31 to 5.77).

synapsesocial.com/papers/6a636ececd7899abd6b70b1ehttps://doi.org/10.1002/14651858.cd013662.pub2
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiopulmonary exercise testing provides a predictive tool for early and late outcomes in abdominal aortic aneurysm patients2011 · 45 citations
  2. 2Cardiopulmonary exercise testing in small abdominal aortic aneurysm: profile, safety, and mortality estimates2011 · 29 citations
  3. 3Changes in Abdominal Aortic Aneurysm Rupture and Short-Term Mortality, 1995–20082012 · 216 citations
  4. 4Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial2016 · 1,104 citations
  5. 5Incidence among men of asymptomatic abdominal aortic aneurysms: estimates from 500 screen detected cases1999 · 84 citations